23D0886046 CLIA NUMBER - AUTUMNWOOD OF DECKERVILLE

Laboratory Demographics

  • CLIA Code: 23D0886046
  • Facility Name: AUTUMNWOOD OF DECKERVILLE
  • Facility Address: 3387 ELLA STREET P O BOX 1000
    DECKERVILLE, MI
    ZIP 48427
  • Facility Phone: 810 376-2145
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KERRY REGENTIN
  • NPI Number: 1669479804
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D0886046
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMNWOOD OF DECKERVILLE
Street 3387 ELLA STREET P O BOX 1000
City DECKERVILLE
State MI
ZIP 48427
Phone 810 376-2145
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2024
Certificate Expiration Date 5/11/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KERRY REGENTIN

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