23D2280536 CLIA NUMBER - TRINITY HEALTH GRAND RAPIDS INFUSION SERVICES

Laboratory Demographics

CLIA Number: 23D2280536

Facility Name: TRINITY HEALTH GRAND RAPIDS INFUSION SERVICES

Facility Address:
250 CHERRY STREET - 2ND FLOOR LACKS CANCER CENTER
GRAND RAPIDS, MI
ZIP 49503
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Facility Phone Number: 616 685-6631

Facility Type: Other - INFUSION CENTER

Certificate Type: Waiver

NPI Number: 1962933416

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2280536
LAB Type	Other - INFUSION CENTER
Facility Name	TRINITY HEALTH GRAND RAPIDS INFUSION SERVICES
Street	250 CHERRY STREET - 2ND FLOOR LACKS CANCER CENTER
City	GRAND RAPIDS
State	MI
ZIP	49503
Phone	616 685-6631
CertificateType	4
CertificateEffectiveDate	4/20/2023
CertificateExpirationDate	4/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024