23D2175772 CLIA NUMBER - FERGUSON DENTAL CENTER

Laboratory Demographics

  • CLIA Code: 23D2175772
  • Facility Name: FERGUSON DENTAL CENTER
  • Facility Address: 101 SHELDON BLVD SE
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 295-7750
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: TIMOTHY HILL
  • NPI Number: 1841449105
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2175772
LAB Type Federally Qualified Health Center
Facility Name FERGUSON DENTAL CENTER
Street 101 SHELDON BLVD SE
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 295-7750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Federally Qualified Health Center
Lab Director TIMOTHY HILL

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