23D1042681 CLIA NUMBER - COOPERSVILLE/POLKTON FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 23D1042681
  • Facility Name: COOPERSVILLE/POLKTON FIRE DEPARTMENT
  • Facility Address: 30 CONRAN DRIVE
    COOPERSVILLE, MI
    ZIP 49404
  • Facility Phone: 616 997-5847
  • Facility Type: Other - MFR
  • Facility Type: Waiver
  • Lab Director: TRAVIS KROLL
  • NPI Number: 1699816124
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 23D1042681
LAB Type Other - MFR
Facility Name COOPERSVILLE/POLKTON FIRE DEPARTMENT
Street 30 CONRAN DRIVE
City COOPERSVILLE
State MI
ZIP 49404
Phone 616 997-5847
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Other - MFR
Lab Director TRAVIS KROLL

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