23D2158969 CLIA NUMBER - LAKE CITY PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 23D2158969
  • Facility Name: LAKE CITY PRIMARY CARE
  • Facility Address: 1866 S MOREY ROAD
    LAKE CITY, MI
    ZIP 49651
  • Facility Phone: 231 839-7282
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER M. DONZELL
  • NPI Number: 1952896151
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2158969
LAB Type Physician Office
Facility Name LAKE CITY PRIMARY CARE
Street 1866 S MOREY ROAD
City LAKE CITY
State MI
ZIP 49651
Phone 231 839-7282
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Physician Office
Lab Director CHRISTOPHER M. DONZELL

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