23D2095065 CLIA NUMBER - WESTERN MICHIGAN TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 23D2095065
  • Facility Name: WESTERN MICHIGAN TREATMENT CENTER
  • Facility Address: 3584 FAIRLANES AVE SW SUITE 2
    GRANDVILLE, MI
    ZIP 49418
  • Facility Phone: 855 380-8272
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DEB BREITRICK
  • NPI Number: 1942670559
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2095065
LAB Type Comp. Outpatient Rehab Facility
Facility Name WESTERN MICHIGAN TREATMENT CENTER
Street 3584 FAIRLANES AVE SW SUITE 2
City GRANDVILLE
State MI
ZIP 49418
Phone 855 380-8272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director DEB BREITRICK

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