23D2019804 CLIA NUMBER - APPLE FAMILY MEDICINE PLC

Laboratory Demographics

  • CLIA Code: 23D2019804
  • Facility Name: APPLE FAMILY MEDICINE PLC
  • Facility Address: 1042 S RAVENNA RD
    RAVENNA, MI
    ZIP 49451
  • Facility Phone: 231 853-2519
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BONNIE J. PLINE
  • NPI Number: 1417279407
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2019804
LAB Type Physician Office
Facility Name APPLE FAMILY MEDICINE PLC
Street 1042 S RAVENNA RD
City RAVENNA
State MI
ZIP 49451
Phone 231 853-2519
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Physician Office
Lab Director BONNIE J. PLINE

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This page was last updated on: 3/20/2025