23D2141314 CLIA NUMBER - WOLVERINE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 23D2141314
  • Facility Name: WOLVERINE DERMATOLOGY
  • Facility Address: 1673 GEZON PARKWAY SW
    WYOMING, MI
    ZIP 49519
  • Facility Phone: 616 243-3376
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RYAN D. FREELAND
  • NPI Number: 1679085161
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 23D2141314
LAB Type Physician Office
Facility Name WOLVERINE DERMATOLOGY
Street 1673 GEZON PARKWAY SW
City WYOMING
State MI
ZIP 49519
Phone 616 243-3376
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Physician Office
Lab Director RYAN D. FREELAND

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