23D2057918 CLIA NUMBER - DUANE WATERS HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 23D2057918
  • Facility Name: DUANE WATERS HEALTH CENTER
  • Facility Address: 3857 COOPER STREET
    JACKSON, MI
    ZIP 49201
  • Facility Phone: 906 495-2275
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: LORI KISSAU
  • NPI Number: 1770031957
  • Taxonomy: 261QP2400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2057918
LAB Type Prison
Facility Name DUANE WATERS HEALTH CENTER
Street 3857 COOPER STREET
City JACKSON
State MI
ZIP 49201
Phone 906 495-2275
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Prison
Lab Director LORI KISSAU

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