23D2250463 CLIA NUMBER - GRAND RAPIDS FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 23D2250463
  • Facility Name: GRAND RAPIDS FIRE DEPARTMENT
  • Facility Address: 38 LAGRAVE AVENUE S E
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 456-3911
  • Facility Type: Other - FIRE DEPT EMS
  • Facility Type: Waiver
  • Lab Director: MARK FANKHAUSER
  • NPI Number: 1851324610
  • Taxonomy: 207VE0102X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 23D2250463
LAB Type Other - FIRE DEPT EMS
Facility Name GRAND RAPIDS FIRE DEPARTMENT
Street 38 LAGRAVE AVENUE S E
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 456-3911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Other - FIRE DEPT EMS
Lab Director MARK FANKHAUSER

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