23D0889475 CLIA NUMBER - STANDALE FAMILY PHYSICIANS

Laboratory Demographics

  • CLIA Code: 23D0889475
  • Facility Name: STANDALE FAMILY PHYSICIANS
  • Facility Address: 3863 LAKE MICHIGAN DRIVE NW
    GRAND RAPIDS, MI
    ZIP 49504
  • Facility Phone: 616 453-2429
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LEONARD A. LEWIS JR
  • NPI Number: 1659408029
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D0889475
LAB Type Physician Office
Facility Name STANDALE FAMILY PHYSICIANS
Street 3863 LAKE MICHIGAN DRIVE NW
City GRAND RAPIDS
State MI
ZIP 49504
Phone 616 453-2429
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Physician Office
Lab Director LEONARD A. LEWIS JR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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