23D0964212 CLIA NUMBER - COREWELL HEALTH PENNOCK HOSPITAL PAIN MANAGEMENT - 840 COOK RD

Laboratory Demographics

  • CLIA Code: 23D0964212
  • Facility Name: COREWELL HEALTH PENNOCK HOSPITAL PAIN MANAGEMENT - 840 COOK RD
  • Facility Address: 840 COOK ROAD
    HASTINGS, MI
    ZIP 49058
  • Facility Phone: 269 945-9520
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIC S. LEEP
  • NPI Number: 1548893209
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0964212
LAB Type Physician Office
Facility Name COREWELL HEALTH PENNOCK HOSPITAL PAIN MANAGEMENT - 840 COOK RD
Street 840 COOK ROAD
City HASTINGS
State MI
ZIP 49058
Phone 269 945-9520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Physician Office
Lab Director ERIC S. LEEP

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This page was last updated on: 3/20/2025