23D2233462 CLIA NUMBER - GREAT LAKES RECOVERY CENTERS

Laboratory Demographics

  • CLIA Code: 23D2233462
  • Facility Name: GREAT LAKES RECOVERY CENTERS
  • Facility Address: 97 S FOURTH STREET SUITE B
    ISHPEMING, MI
    ZIP 49849
  • Facility Phone: 906 464-0002
  • Facility Type: Other - BEHAVIORAL HEALTH TX FAC
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. GROSSMAN
  • NPI Number: 1104571900
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2233462
LAB Type Other - BEHAVIORAL HEALTH TX FAC
Facility Name GREAT LAKES RECOVERY CENTERS
Street 97 S FOURTH STREET SUITE B
City ISHPEMING
State MI
ZIP 49849
Phone 906 464-0002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Other - BEHAVIORAL HEALTH TX FAC
Lab Director MICHAEL S. GROSSMAN

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