23D2104292 CLIA NUMBER - HACKLEY COMMUNITY CARE OAKRIDGE TEEN HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 23D2104292
  • Facility Name: HACKLEY COMMUNITY CARE OAKRIDGE TEEN HEALTH CENTER
  • Facility Address: 251 S WOLF LAKE ROAD
    MUSKEGON, MI
    ZIP 49442
  • Facility Phone: 231 737-1335
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: LESLIE N. KINGSLEY
  • NPI Number: 1861758658
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2104292
LAB Type Federally Qualified Health Center
Facility Name HACKLEY COMMUNITY CARE OAKRIDGE TEEN HEALTH CENTER
Street 251 S WOLF LAKE ROAD
City MUSKEGON
State MI
ZIP 49442
Phone 231 737-1335
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Federally Qualified Health Center
Lab Director LESLIE N. KINGSLEY

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