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23D2034533 CLIA NUMBER - PACE OF SOUTHWEST MICHIGAN

Laboratory Demographics

CLIA Number: 23D2034533

Facility Name: PACE OF SOUTHWEST MICHIGAN

Facility Address:
2900 LAKEVIEW AVENUE
SAINT JOSEPH, MI
ZIP 49085
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Facility Phone Number: 269 982-7767

Facility Type: Other - PACE CLINIC

Certificate Type: Waiver
NPI Number: 1568709392

Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.

CLIA Record

Field Name Field Value
CLIA Number 23D2034533
LAB Type Other - PACE CLINIC
Facility Name PACE OF SOUTHWEST MICHIGAN
Street 2900 LAKEVIEW AVENUE
City SAINT JOSEPH
State MI
ZIP 49085
Phone 269 982-7767
CertificateType 4
CertificateEffectiveDate 12/28/2023
CertificateExpirationDate 12/27/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024