23D2206648 CLIA NUMBER - EMMANUEL HOSPICE

Laboratory Demographics

  • CLIA Code: 23D2206648
  • Facility Name: EMMANUEL HOSPICE
  • Facility Address: 401 HALL STREET SW SUITE 263
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 719-0919
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DANIELLE HEFFRON
  • NPI Number: 1609491109
  • Taxonomy: 2080P0214X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D2206648
LAB Type Hospice
Facility Name EMMANUEL HOSPICE
Street 401 HALL STREET SW SUITE 263
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 719-0919
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Hospice
Lab Director DANIELLE HEFFRON

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