23D0676107 CLIA NUMBER - EVERGREEN SENIOR CARE AND REHAB

Laboratory Demographics

  • CLIA Code: 23D0676107
  • Facility Name: EVERGREEN SENIOR CARE AND REHAB
  • Facility Address: 111 EVERGREEN ROAD
    SPRINGFIELD, MI
    ZIP 49037
  • Facility Phone: 269 969-6110
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ADAM PATRICK
  • NPI Number: 1992855316
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D0676107
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EVERGREEN SENIOR CARE AND REHAB
Street 111 EVERGREEN ROAD
City SPRINGFIELD
State MI
ZIP 49037
Phone 269 969-6110
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 ADAM PATRICK

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