23D1053227 CLIA NUMBER - ROYALTON MANOR

Laboratory Demographics

  • CLIA Code: 23D1053227
  • Facility Name: ROYALTON MANOR
  • Facility Address: 288 PEACE BLVD
    SAINT JOSEPH, MI
    ZIP 49085
  • Facility Phone: 269 556-9050
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: AMY S. WITTENBURG
  • NPI Number: 1598816423
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D1053227
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ROYALTON MANOR
Street 288 PEACE BLVD
City SAINT JOSEPH
State MI
ZIP 49085
Phone 269 556-9050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director AMY S. WITTENBURG

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