23D0697765 CLIA NUMBER - WHITE LAKE FAMILY WELLNESS INC

Laboratory Demographics

  • CLIA Code: 23D0697765
  • Facility Name: WHITE LAKE FAMILY WELLNESS INC
  • Facility Address: 9178 HIGHLAND RD SUITE 1
    WHITE LAKE, MI
    ZIP 48386
  • Facility Phone: 248 698-1999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHAKA P. CHIPAWE
  • NPI Number: 1609095256
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0697765
LAB Type Physician Office
Facility Name WHITE LAKE FAMILY WELLNESS INC
Street 9178 HIGHLAND RD SUITE 1
City WHITE LAKE
State MI
ZIP 48386
Phone 248 698-1999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director CHAKA P. CHIPAWE

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