23D2008765 CLIA NUMBER - AMC MOBILE ANESTHESIA

Laboratory Demographics

  • CLIA Code: 23D2008765
  • Facility Name: AMC MOBILE ANESTHESIA
  • Facility Address: 3333 EVERGREEN DRIVE NE
    GRAND RAPIDS, MI
    ZIP 49525
  • Facility Phone: 616 284-3142
  • Facility Type: Other - MOBILE ANESTHESIA UNIT
  • Facility Type: Waiver
  • Lab Director: CANDACE L. BROTHERTON
  • NPI Number: 1376868372
  • Taxonomy: 207L00000X - Anesthesiology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D2008765
LAB Type Other - MOBILE ANESTHESIA UNIT
Facility Name AMC MOBILE ANESTHESIA
Street 3333 EVERGREEN DRIVE NE
City GRAND RAPIDS
State MI
ZIP 49525
Phone 616 284-3142
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Other - MOBILE ANESTHESIA UNIT
Lab Director CANDACE L. BROTHERTON

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