23D0948005 CLIA NUMBER - SOUTHWEST MICHIGAN DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 23D0948005
  • Facility Name: SOUTHWEST MICHIGAN DERMATOLOGY
  • Facility Address: 3000 OLD CENTRE ROAD
    PORTAGE, MI
    ZIP 49024
  • Facility Phone: 269 321-7546
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: CRAIG A. MOHNEY
  • NPI Number: 1902847098
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 23D0948005
LAB Type Physician Office
Facility Name SOUTHWEST MICHIGAN DERMATOLOGY
Street 3000 OLD CENTRE ROAD
City PORTAGE
State MI
ZIP 49024
Phone 269 321-7546
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/13/2024
Certificate Expiration Date 10/12/2026
Facility Type Physician Office
Lab Director CRAIG A. MOHNEY

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