23D2140916 CLIA NUMBER - COREWELL HEALTH FAMILY, INTERNAL AND PEDIATRIC MEDICINE - ADA

Laboratory Demographics

CLIA Number: 23D2140916

Facility Name: COREWELL HEALTH FAMILY, INTERNAL AND PEDIATRIC MEDICINE - ADA

Facility Address:
7128 FULTON STREET SE
ADA, MI
ZIP 49301
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Facility Phone Number: 616 825-3530

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1467099267

Taxonomy: 172A00000X - Driver
A person employed to operate a motor vehicle as a carrier of persons or property.

CLIA Record

Field Name	Field Value
CLIA Number	23D2140916
LAB Type	Physician Office
Facility Name	COREWELL HEALTH FAMILY, INTERNAL AND PEDIATRIC MEDICINE - ADA
Street	7128 FULTON STREET SE
City	ADA
State	MI
ZIP	49301
Phone	616 825-3530
CertificateType	3
CertificateEffectiveDate	12/4/2023
CertificateExpirationDate	12/3/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024