23D0936161 CLIA NUMBER - ODYSSEY HEALTHCARE HOLDING COMPANY DBA HEARTLAND HOSPICE (GRAND RAPIDS)

Laboratory Demographics

  • CLIA Code: 23D0936161
  • Facility Name: ODYSSEY HEALTHCARE HOLDING COMPANY DBA HEARTLAND HOSPICE (GRAND RAPIDS)
  • Facility Address: 695 KENMOOR AVENUE SE SUITE B
    GRAND RAPIDS, MI
    ZIP 49546
  • Facility Phone: 616 956-0636
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE L. BEASLEY
  • NPI Number: 1699728980
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 23D0936161
LAB Type Hospice
Facility Name ODYSSEY HEALTHCARE HOLDING COMPANY DBA HEARTLAND HOSPICE (GRAND RAPIDS)
Street 695 KENMOOR AVENUE SE SUITE B
City GRAND RAPIDS
State MI
ZIP 49546
Phone 616 956-0636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Hospice
Lab Director SELECE L. BEASLEY

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