23D0378762 CLIA NUMBER - GRASS LAKE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 23D0378762
  • Facility Name: GRASS LAKE MEDICAL CENTER
  • Facility Address: 12337 E MICHIGAN PO BOX 246
    GRASS LAKE, MI
    ZIP 49240
  • Facility Phone: 517 522-8403
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK E. LEVENTER MD
  • NPI Number: 1629233150
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 23D0378762
LAB Type Physician Office
Facility Name GRASS LAKE MEDICAL CENTER
Street 12337 E MICHIGAN PO BOX 246
City GRASS LAKE
State MI
ZIP 49240
Phone 517 522-8403
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 MARK E. LEVENTER MD

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This page was last updated on: 9/29/2025