23D2294278 CLIA NUMBER - GRAY REIGN MEDICAL

Laboratory Demographics

CLIA Number: 23D2294278

Facility Name: GRAY REIGN MEDICAL

Facility Address:
6255 28TH STREET SUITE 2
GRAND RAPIDS, MI
ZIP 49546
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Facility Phone Number: 517 862-5207

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134909575

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	23D2294278
LAB Type	Physician Office
Facility Name	GRAY REIGN MEDICAL
Street	6255 28TH STREET SUITE 2
City	GRAND RAPIDS
State	MI
ZIP	49546
Phone	517 862-5207
CertificateType	4
CertificateEffectiveDate	11/21/2023
CertificateExpirationDate	11/20/2025
FacilityType	Waiver

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