23D2096565 CLIA NUMBER - PENNFIELD PREMIER LIVING NORTH

Laboratory Demographics

  • CLIA Code: 23D2096565
  • Facility Name: PENNFIELD PREMIER LIVING NORTH
  • Facility Address: 632 NORTH AVENUE
    BATTLE CREEK, MI
    ZIP 49017
  • Facility Phone: 269 282-1670
  • Facility Type: Other - ADULT FOSTER CARE HOME
  • Facility Type: Waiver
  • Lab Director: RENEE C. KELLY
  • NPI Number: 1205242294
  • Taxonomy: 146N00000X - Emergency Medical Technician, Basic

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CLIA Record

Field Name Field Value
CLIA Number 23D2096565
LAB Type Other - ADULT FOSTER CARE HOME
Facility Name PENNFIELD PREMIER LIVING NORTH
Street 632 NORTH AVENUE
City BATTLE CREEK
State MI
ZIP 49017
Phone 269 282-1670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2024
Certificate Expiration Date 11/16/2026
Facility Type Other - ADULT FOSTER CARE HOME
Lab Director RENEE C. KELLY

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