23D2134178 CLIA NUMBER - CRYSTAL LAKE CLINIC, P C

Laboratory Demographics

  • CLIA Code: 23D2134178
  • Facility Name: CRYSTAL LAKE CLINIC, P C
  • Facility Address: 650 S WEST BAY SHORE DRIVE
    SUTTONS BAY, MI
    ZIP 49682
  • Facility Phone: (231) 882-9661
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACOB G. FLYNN
  • NPI Number: 1134491731
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2134178
LAB Type Physician Office
Facility Name CRYSTAL LAKE CLINIC, P C
Street 650 S WEST BAY SHORE DRIVE
City SUTTONS BAY
State MI
ZIP 49682
Phone 2318829661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2025
Certificate Expiration Date 7/26/2027
Facility Type Physician Office
Lab Director JACOB G. FLYNN

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This page was last updated on: 5/18/2026