23D0975401 CLIA NUMBER - FOUNTAIN VIEW ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 23D0975401
  • Facility Name: FOUNTAIN VIEW ASSISTED LIVING
  • Facility Address: 640 W RANDALL STREET
    COOPERSVILLE, MI
    ZIP 49404
  • Facility Phone: 616 285-0569
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TARA FRAZIER
  • NPI Number: 1154657591
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D0975401
LAB Type Assisted Living Facility
Facility Name FOUNTAIN VIEW ASSISTED LIVING
Street 640 W RANDALL STREET
City COOPERSVILLE
State MI
ZIP 49404
Phone 616 285-0569
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2024
Certificate Expiration Date 7/6/2026
Facility Type Assisted Living Facility
Lab Director TARA FRAZIER

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