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23D0975403 CLIA NUMBER - FOUNTAIN VIEW OF FREMONT

Laboratory Demographics

CLIA Number: 23D0975403

Facility Name: FOUNTAIN VIEW OF FREMONT

Facility Address:
102 HILLCREST AVE
FREMONT, MI
ZIP 49412
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Facility Phone Number: 616 285-0569

Facility Type: Other

Certificate Type: Waiver
NPI Number: 1720196819

Taxonomy: 291U00000X - Clinical Medical Laboratory
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

CLIA Record

Field Name Field Value
CLIA Number 23D0975403
LAB Type Other
Facility Name FOUNTAIN VIEW OF FREMONT
Street 102 HILLCREST AVE
City FREMONT
State MI
ZIP 49412
Phone 616 285-0569
CertificateType 4
CertificateEffectiveDate 7/7/2022
CertificateExpirationDate 7/6/2024
FacilityType Waiver

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