23D2211219 CLIA NUMBER - COREWELL HEALTH GR HOSP RAD ONC - LEMMEN-HOLTON

Laboratory Demographics

  • CLIA Code: 23D2211219
  • Facility Name: COREWELL HEALTH GR HOSP RAD ONC - LEMMEN-HOLTON
  • Facility Address: 145 MICHIGAN ST NE SUITE 1100 MC204
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 486-5750
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: ERIC P. BUTH
  • NPI Number: 1013453760
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2211219
LAB Type Ancillary Testing Site in Health Care Center
Facility Name COREWELL HEALTH GR HOSP RAD ONC - LEMMEN-HOLTON
Street 145 MICHIGAN ST NE SUITE 1100 MC204
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 486-5750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director ERIC P. BUTH

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