23D2310894 CLIA NUMBER - PASADENA VILLA - GREAT LAKES

Laboratory Demographics

  • CLIA Code: 23D2310894
  • Facility Name: PASADENA VILLA - GREAT LAKES
  • Facility Address: 393 E ROOSEVELT AVENUE
    BATTLE CREEK, MI
    ZIP 49017
  • Facility Phone: 269 400-9790
  • Facility Type: Other - RESIDENTIAL TREATMENT
  • Facility Type: Waiver
  • Lab Director: JOHN KUPFNER
  • NPI Number: 1598505968
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D2310894
LAB Type Other - RESIDENTIAL TREATMENT
Facility Name PASADENA VILLA - GREAT LAKES
Street 393 E ROOSEVELT AVENUE
City BATTLE CREEK
State MI
ZIP 49017
Phone 269 400-9790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Other - RESIDENTIAL TREATMENT
Lab Director JOHN KUPFNER

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