CLIA lab
CLIA 23D2049142: Crystal Lake Clinic P C
Manton, MI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 23D2049142 belongs to Crystal Lake Clinic P C in Manton, MI.
Certificate of Waiver, effective October 31, 2024, expires October 30, 2026.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 31, 2024
- Certificate expiration
- October 30, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 31, 2012
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 23D2049142
- Lab name
- Crystal Lake Clinic P C
- Address
- 115 E 7th Street, Manton, MI 49663
- Phone
- (231) 882-9661
- Fax
- (231) 882-9616
Annual test volume the lab reported
- Waived tests
- 1,300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Crystal Lake Clinic P C in Manton?
23D2049142, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Crystal Lake Clinic P C hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 23D2049142 expire?
The CMS file lists October 30, 2026 as the certificate expiration date; the certificate took effect October 31, 2024.