NPIMap

Organization Active NPI

Northwest Michigan Community Health Agency

Doing business as Northern Michigan Regional Laboratory

  • Clinical Medical Laboratory
  • Gaylord, MI
National Provider Identifier
1659983872
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY
Doing business as
Northern Michigan Regional Laboratory
Practice address
95 Livingston Blvd
Gaylord, MI 49735-9464
Phone
(989) 731-6878
NPI assigned
Aug 19, 2020
Last updated
Dec 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shannon Leigh Klonowski
Title
Health Officer
Phone
(231) 547-7613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

95 Livingston Blvd
Gaylord, MI 49735-9464

Mailing address

220 W Garfield Ave
Charlevoix, MI 49720-1631
Phone (231) 547-6523

Other names 1

  • Northern Michigan Regional Laboratory Doing business as

National Provider Directory

National Provider Directory
Part of
Northwest Michigan Agency

Locations

209 Portage Dr
Bellaire, MI 49615
Phone (231) 533-8670

95 Livingston Blvd
Gaylord, MI 49735
Phone (989) 731-0961

95 Livingston Blvd
Ste A
Gaylord, MI 49735
Phone (989) 732-1794

3434 M 119
Ste A
Harbor Springs, MI 49740
Phone (231) 347-6014

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1659983872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W GARFIELD AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201631",
            "telephone_number": "231-547-6523",
            "fax_number": "231-547-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 LIVINGSTON BLVD",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359464",
            "telephone_number": "989-731-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY",
        "enumeration_date": "2020-08-19",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "KLONOWSKI",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "231-547-7613"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Michigan Regional Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northern Michigan Regional Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaylord, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.