23D2193492 CLIA NUMBER - WOODLAND TERRACE AT LONGMEADOW

Laboratory Demographics

  • CLIA Code: 23D2193492
  • Facility Name: WOODLAND TERRACE AT LONGMEADOW
  • Facility Address: 13 LONGMEADOW VILLAGE DRIVE
    NILES, MI
    ZIP 49120
  • Facility Phone: 574 261-1124
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TODD DOCKERTY
  • NPI Number: 1710362264
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D2193492
LAB Type Assisted Living Facility
Facility Name WOODLAND TERRACE AT LONGMEADOW
Street 13 LONGMEADOW VILLAGE DRIVE
City NILES
State MI
ZIP 49120
Phone 574 261-1124
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Assisted Living Facility
Lab Director TODD DOCKERTY

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