23D1037078 CLIA NUMBER - LEELANAU OPCO, LLC

Laboratory Demographics

  • CLIA Code: 23D1037078
  • Facility Name: LEELANAU OPCO, LLC
  • Facility Address: 124 W FOURTH STREET
    SUTTONS BAY, MI
    ZIP 49682
  • Facility Phone: 231 271-1200
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SHANNON MIENK
  • NPI Number: 1396261681
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D1037078
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LEELANAU OPCO, LLC
Street 124 W FOURTH STREET
City SUTTONS BAY
State MI
ZIP 49682
Phone 231 271-1200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SHANNON MIENK

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