23D1045434 CLIA NUMBER - OTTAWA HILLS HIGH SCHOOL HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 23D1045434
  • Facility Name: OTTAWA HILLS HIGH SCHOOL HEALTH CENTER
  • Facility Address: 2055 ROSEWOOD ST SE
    GRAND RAPIDS, MI
    ZIP 49506
  • Facility Phone: 616 295-7750
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: JENNY BUSH
  • NPI Number: 1124187471
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1045434
LAB Type Federally Qualified Health Center
Facility Name OTTAWA HILLS HIGH SCHOOL HEALTH CENTER
Street 2055 ROSEWOOD ST SE
City GRAND RAPIDS
State MI
ZIP 49506
Phone 616 295-7750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2023
Certificate Expiration Date 10/18/2025
Facility Type Federally Qualified Health Center
Lab Director JENNY BUSH

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