23D2325871 CLIA NUMBER - GRAND PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 23D2325871
  • Facility Name: GRAND PRIMARY CARE
  • Facility Address: 3550 FAIRLANES AVENUE SW SUITE A
    GRANDVILLE, MI
    ZIP 49418
  • Facility Phone: 616 333-5913
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COURTNEY R. SMITH
  • NPI Number: 1780475475
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2325871
LAB Type Physician Office
Facility Name GRAND PRIMARY CARE
Street 3550 FAIRLANES AVENUE SW SUITE A
City GRANDVILLE
State MI
ZIP 49418
Phone 616 333-5913
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Physician Office
Lab Director COURTNEY R. SMITH

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