23D2195943 CLIA NUMBER - GLDE, PLLC DBA GREAT LAKES DENTAL EXCELLENCE

Laboratory Demographics

  • CLIA Code: 23D2195943
  • Facility Name: GLDE, PLLC DBA GREAT LAKES DENTAL EXCELLENCE
  • Facility Address: 5978 S HARVEY STREET
    MUSKEGON, MI
    ZIP 49444
  • Facility Phone: 231 799-0404
  • Facility Type: Other - DENTAL
  • Facility Type: Waiver
  • Lab Director: THERESA A. HEGEDUS
  • NPI Number: 1427698851
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 23D2195943
LAB Type Other - DENTAL
Facility Name GLDE, PLLC DBA GREAT LAKES DENTAL EXCELLENCE
Street 5978 S HARVEY STREET
City MUSKEGON
State MI
ZIP 49444
Phone 231 799-0404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Other - DENTAL
Lab Director THERESA A. HEGEDUS

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