23D0379471 CLIA NUMBER - WESTERN MICHIGAN UROLOGICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 23D0379471
  • Facility Name: WESTERN MICHIGAN UROLOGICAL ASSOCIATES
  • Facility Address: 577 MICHIGAN AVENUE 201
    HOLLAND, MI
    ZIP 49423
  • Facility Phone: 616 392-1816
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: MICHAEL A. TRAVER
  • NPI Number: 1952428948
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 23D0379471
LAB Type Practitioner Other
Facility Name WESTERN MICHIGAN UROLOGICAL ASSOCIATES
Street 577 MICHIGAN AVENUE 201
City HOLLAND
State MI
ZIP 49423
Phone 616 392-1816
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 Practitioner Other
Lab Director MICHAEL A. TRAVER

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