23D2114735 CLIA NUMBER - PATIENT ONE CARE

Laboratory Demographics

  • CLIA Code: 23D2114735
  • Facility Name: PATIENT ONE CARE
  • Facility Address: 1740 28TH STREET SE
    GRAND RAPIDS, MI
    ZIP 49508
  • Facility Phone: 616 323-3999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOBEDA A. SHEULY
  • NPI Number: 1770934325
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2114735
LAB Type Physician Office
Facility Name PATIENT ONE CARE
Street 1740 28TH STREET SE
City GRAND RAPIDS
State MI
ZIP 49508
Phone 616 323-3999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2024
Certificate Expiration Date 10/7/2026
Facility Type Physician Office
Lab Director JOBEDA A. SHEULY

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