23D0972070 CLIA NUMBER - COREWELL HEALTH LAKELAND HOSPITALS HEART & VASCULAR - ROYALTON

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Laboratory Demographics

CLIA Number: 23D0972070

Facility Name: COREWELL HEALTH LAKELAND HOSPITALS HEART & VASCULAR - ROYALTON

Facility Address:
3950 HOLLYWOOD RD SUITE 110 ENTRANCE B
ST JOSEPH, MI
ZIP 49085
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Facility Phone Number: 269 985-1000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336657824

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	23D0972070
LAB Type	Physician Office
Facility Name	COREWELL HEALTH LAKELAND HOSPITALS HEART & VASCULAR - ROYALTON
Street	3950 HOLLYWOOD RD SUITE 110 ENTRANCE B
City	ST JOSEPH
State	MI
ZIP	49085
Phone	269 985-1000
CertificateType	4
CertificateEffectiveDate	3/29/2024
CertificateExpirationDate	3/28/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024