23D0899819 CLIA NUMBER - COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - GUN LAKE

Laboratory Demographics

  • CLIA Code: 23D0899819
  • Facility Name: COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - GUN LAKE
  • Facility Address: 12851 W M-179 HWY
    WAYLAND, MI
    ZIP 49348
  • Facility Phone: 877 377-7322
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JOSHUA D. KNUDSON
  • NPI Number: 1801250907
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0899819
LAB Type Rural Health Clinic
Facility Name COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - GUN LAKE
Street 12851 W M-179 HWY
City WAYLAND
State MI
ZIP 49348
Phone 877 377-7322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Rural Health Clinic
Lab Director JOSHUA D. KNUDSON

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