23D0381643 CLIA NUMBER - GRANDVUE CHARLEVOIX COUNTY MEDICAL CARE FACILITY

Laboratory Demographics

  • CLIA Code: 23D0381643
  • Facility Name: GRANDVUE CHARLEVOIX COUNTY MEDICAL CARE FACILITY
  • Facility Address: 1728 S PENINSULA RD
    EAST JORDAN, MI
    ZIP 49727
  • Facility Phone: 231 536-2286
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SHANNAN BUTLER
  • NPI Number: 1447216478
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D0381643
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GRANDVUE CHARLEVOIX COUNTY MEDICAL CARE FACILITY
Street 1728 S PENINSULA RD
City EAST JORDAN
State MI
ZIP 49727
Phone 231 536-2286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SHANNAN BUTLER

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