23D2264073 CLIA NUMBER - TRINITY HEALTH MEDICAL GROUP - ACADEMIC INTERNAL MEDICINE - GRAND RAPIDS

Laboratory Demographics

  • CLIA Code: 23D2264073
  • Facility Name: TRINITY HEALTH MEDICAL GROUP - ACADEMIC INTERNAL MEDICINE - GRAND RAPIDS
  • Facility Address: 300 LAFAYETTE SE SUITE 3000
    GRAND RAPIDS, MI
    ZIP 49503
  • Facility Phone: 616 685-6919
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID DOUD
  • NPI Number: 1962933416
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2264073
LAB Type Physician Office
Facility Name TRINITY HEALTH MEDICAL GROUP - ACADEMIC INTERNAL MEDICINE - GRAND RAPIDS
Street 300 LAFAYETTE SE SUITE 3000
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 685-6919
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Physician Office
Lab Director DAVID DOUD

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