23D2225691 CLIA NUMBER - PREMIERMD PHYSICIANS, INC

Laboratory Demographics

  • CLIA Code: 23D2225691
  • Facility Name: PREMIERMD PHYSICIANS, INC
  • Facility Address: 16986 ROBBINS ROAD SUITE 180
    GRAND HAVEN, MI
    ZIP 49417
  • Facility Phone: 616 213-0253
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID K. WILSON
  • NPI Number: 1598304701
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2225691
LAB Type Physician Office
Facility Name PREMIERMD PHYSICIANS, INC
Street 16986 ROBBINS ROAD SUITE 180
City GRAND HAVEN
State MI
ZIP 49417
Phone 616 213-0253
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Physician Office
Lab Director DAVID K. WILSON

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