23D2222969 CLIA NUMBER - MICHIGAN STATE UNIVERSITY SPORTS MEDICINE SATELLITE

Laboratory Demographics

  • CLIA Code: 23D2222969
  • Facility Name: MICHIGAN STATE UNIVERSITY SPORTS MEDICINE SATELLITE
  • Facility Address: 771 CHESTNUT ROAD ROOM 131
    EAST LANSING, MI
    ZIP 48824
  • Facility Phone: 517 353-4412
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFF KOVAN
  • NPI Number: 1083666820
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 23D2222969
LAB Type Physician Office
Facility Name MICHIGAN STATE UNIVERSITY SPORTS MEDICINE SATELLITE
Street 771 CHESTNUT ROAD ROOM 131
City EAST LANSING
State MI
ZIP 48824
Phone 517 353-4412
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Physician Office
Lab Director JEFF KOVAN

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