23D0366785 CLIA NUMBER - PACKARD HEALTH

Laboratory Demographics

  • CLIA Code: 23D0366785
  • Facility Name: PACKARD HEALTH
  • Facility Address: 2650 CARPENTER ROAD
    ANN ARBOR, MI
    ZIP 48108
  • Facility Phone: (734) 971-1073
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JERRY S. WALDEN
  • NPI Number: 1205538584
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0366785
LAB Type Physician Office
Facility Name PACKARD HEALTH
Street 2650 CARPENTER ROAD
City ANN ARBOR
State MI
ZIP 48108
Phone 7349711073
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JERRY S. WALDEN

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This page was last updated on: 5/18/2026