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23D2169938 CLIA NUMBER - COREWELL HEALTH MEDICAL GROUP WEST RETAIL CLINIC - WYOMING

Laboratory Demographics

CLIA Number: 23D2169938

Facility Name: COREWELL HEALTH MEDICAL GROUP WEST RETAIL CLINIC - WYOMING

Facility Address:
5500 CLYDE PARK AVE SW
WYOMING, MI
ZIP 49509
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Facility Phone Number: 616 486-9530

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1275190456

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 23D2169938
LAB Type Physician Office
Facility Name COREWELL HEALTH MEDICAL GROUP WEST RETAIL CLINIC - WYOMING
Street 5500 CLYDE PARK AVE SW
City WYOMING
State MI
ZIP 49509
Phone 616 486-9530
CertificateType 4
CertificateEffectiveDate 7/31/2023
CertificateExpirationDate 7/30/2025
FacilityType Waiver

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