23D2066491 CLIA NUMBER - THE WASHTENAW PACE, INC

Laboratory Demographics

CLIA Code: 23D2066491
Facility Name: THE WASHTENAW PACE, INC
Facility Address: 2940 ELLSWORTH ROAD
YPSILANTI, MI
ZIP 48197
Facility Phone: 734 572-5777
Facility Type: Other - PACE CENTER
Facility Type: Waiver
Lab Director: TERRI MACK
NPI Number: 1174945364
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	23D2066491
LAB Type	Other - PACE CENTER
Facility Name	THE WASHTENAW PACE, INC
Street	2940 ELLSWORTH ROAD
City	YPSILANTI
State	MI
ZIP	48197
Phone	734 572-5777
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/27/2025
Certificate Expiration Date	9/26/2027
Facility Type	Other - PACE CENTER
Lab Director	TERRI MACK

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