23D1105127 CLIA NUMBER - COREWELL HEALTH GYNECOLOGIC SURGICAL SPECIALITIES - 25 MICHIGAN ST NE

Laboratory Demographics

  • CLIA Code: 23D1105127
  • Facility Name: COREWELL HEALTH GYNECOLOGIC SURGICAL SPECIALITIES - 25 MICHIGAN ST NE
  • Facility Address: 25 MICHIGAN ST NE STE 6200
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 391-3304
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ELIZABETH A. LEARY
  • NPI Number: 1992016505
  • Taxonomy: 208800000X - Urology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D1105127
LAB Type Physician Office
Facility Name COREWELL HEALTH GYNECOLOGIC SURGICAL SPECIALITIES - 25 MICHIGAN ST NE
Street 25 MICHIGAN ST NE STE 6200
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 391-3304
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Physician Office
Lab Director ELIZABETH A. LEARY

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