23D2051558 CLIA NUMBER - DERMATOLOGY AT MIDTOWNE, PC

Laboratory Demographics

  • CLIA Code: 23D2051558
  • Facility Name: DERMATOLOGY AT MIDTOWNE, PC
  • Facility Address: 555 MIDTOWNE ST NE, SUITE 301
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 248-8864
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DIPA S. PATEL
  • NPI Number: 1780933432
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D2051558
LAB Type Physician Office
Facility Name DERMATOLOGY AT MIDTOWNE, PC
Street 555 MIDTOWNE ST NE, SUITE 301
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 248-8864
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 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Physician Office
Lab Director DIPA S. PATEL

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