23D2193495 CLIA NUMBER - WOODLAND TERRACE OF PAW PAW LAKE

Laboratory Demographics

  • CLIA Code: 23D2193495
  • Facility Name: WOODLAND TERRACE OF PAW PAW LAKE
  • Facility Address: 6786 RED ARROW HIGHWAY
    COLOMA, MI
    ZIP 49038
  • Facility Phone: 574 261-1124
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TODD DOCKERTY
  • NPI Number: 1518342062
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D2193495
LAB Type Assisted Living Facility
Facility Name WOODLAND TERRACE OF PAW PAW LAKE
Street 6786 RED ARROW HIGHWAY
City COLOMA
State MI
ZIP 49038
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