23D2047786 CLIA NUMBER - WYOMING COMMUNITY HEALTH CENTER

Laboratory Demographics

CLIA Code: 23D2047786
Facility Name: WYOMING COMMUNITY HEALTH CENTER
Facility Address: 2929 BURLINGAME AVENUE S W
WYOMING, MI
ZIP 49509
Facility Phone: 616 965-8200
Facility Type: Federally Qualified Health Center
Facility Type: Microscopy
Lab Director: JERRICA KALLIO
NPI Number: 1184974263
Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name	Field Value
CLIA Number	23D2047786
LAB Type	Federally Qualified Health Center
Facility Name	WYOMING COMMUNITY HEALTH CENTER
Street	2929 BURLINGAME AVENUE S W
City	WYOMING
State	MI
ZIP	49509
Phone	616 965-8200
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	6/26/2025
Certificate Expiration Date	6/25/2027
Facility Type	Federally Qualified Health Center
Lab Director	JERRICA KALLIO

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