23D1090689 CLIA NUMBER - GREAT LAKES EYE CARE

Laboratory Demographics

  • CLIA Code: 23D1090689
  • Facility Name: GREAT LAKES EYE CARE
  • Facility Address: 2848 NILES ROAD
    SAINT JOSEPH, MI
    ZIP 49085
  • Facility Phone: 269 428-3300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID L. COOKE
  • NPI Number: 1003273129
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D1090689
LAB Type Physician Office
Facility Name GREAT LAKES EYE CARE
Street 2848 NILES ROAD
City SAINT JOSEPH
State MI
ZIP 49085
Phone 269 428-3300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Physician Office
Lab Director DAVID L. COOKE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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