23D0651049 CLIA NUMBER - HOLLAND HOME - RAYBROOK MANOR

Laboratory Demographics

  • CLIA Code: 23D0651049
  • Facility Name: HOLLAND HOME - RAYBROOK MANOR
  • Facility Address: 2121 RAYBROOK SE
    GRAND RAPIDS, MI
    ZIP 49546
  • Facility Phone: 616 235-5710
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RONALD DUEMLER
  • NPI Number: 1033287792
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D0651049
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HOLLAND HOME - RAYBROOK MANOR
Street 2121 RAYBROOK SE
City GRAND RAPIDS
State MI
ZIP 49546
Phone 616 235-5710
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 RONALD DUEMLER

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