23D2097174 CLIA NUMBER - THE CASCADE PACE, INC

Laboratory Demographics

CLIA Code: 23D2097174
Facility Name: THE CASCADE PACE, INC
Facility Address: 2282 SPRINGPORT ROAD
JACKSON, MI
ZIP 49202
Facility Phone: 517 768-9791
Facility Type: Other - PACE DAY/MEDICAL CTR
Facility Type: Waiver
Lab Director: GINNY L. BRODERICK
NPI Number: 1083071823
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	23D2097174
LAB Type	Other - PACE DAY/MEDICAL CTR
Facility Name	THE CASCADE PACE, INC
Street	2282 SPRINGPORT ROAD
City	JACKSON
State	MI
ZIP	49202
Phone	517 768-9791
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	6/10/2025
Certificate Expiration Date	6/9/2027
Facility Type	Other - PACE DAY/MEDICAL CTR
Lab Director	GINNY L. BRODERICK

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