23D2150033 CLIA NUMBER - LEELANAU FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 23D2150033
  • Facility Name: LEELANAU FAMILY PRACTICE
  • Facility Address: 718 N SAINT JOSEPH STREET SUITE K1
    SUTTONS BAY, MI
    ZIP 49682
  • Facility Phone: 231 386-0088
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JESSICA M. PAQUETTE
  • NPI Number: 1386132090
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2150033
LAB Type Physician Office
Facility Name LEELANAU FAMILY PRACTICE
Street 718 N SAINT JOSEPH STREET SUITE K1
City SUTTONS BAY
State MI
ZIP 49682
Phone 231 386-0088
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 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Physician Office
Lab Director JESSICA M. PAQUETTE

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