GRACE HAVEN ASSISTED LIVING - LABORATORY
NPI 1053636167
Clinical Medical Laboratory in Saint Johns, MI

Active since March 31, 2010CLIA 23D1102195 · Waiver
1507 GLASTONBURY DR, SAINT JOHNS, MI 48879(989) 224-1650 Get Directions Write a Review

NPPES record last updated: March 23, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grace Haven Assisted Living - Laboratory NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE HAVEN ASSISTED LIVING - LABORATORY (NPI 1053636167) is a healthcare organization registered as a clinical medical laboratory in Saint Johns, Michigan and active in the NPI registry since March 2010. The organization holds a CLIA Waiver certificate valid through October 6, 2026 and lists Thomas Nobel, President, as its authorized official.

NPPES Registry Identity

NPI1053636167
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameGRACE HAVEN ASSISTED LIVING LLC
Location Address1507 GLASTONBURY DRSaint Johns, MI 48879-8235
Mailing Address1507 Glastonbury DrSaint Johns, MI 48879-8235 · (989) 224-1650
Organization SubpartNo
Authorized OfficialThomas NobelPresident · (989) 224-1650
Enumeration DateMarch 31, 2010
Last NPPES UpdateMarch 23, 2011
NPI 1053636167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in MI · 23D1102195
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
1507 GLASTONBURY DR, Saint Johns, MI 48879

Other Names 1

Doing Business AsGrace Haven Assisted Living - Laboratory

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1102195

Grace Haven Assisted Living · Saint Johns, MI
Active · expires Oct 6, 2026
CLIA Number23D1102195
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 7, 2024
Certificate Expiration DateOctober 6, 2026
Laboratory DirectorJennifer Herald
Laboratory Phone(989) 224-1650
Laboratory LocationGrace Haven Assisted Living1507 Glastonbury Drive, Saint Johns, MI 48879
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Assisted Living Facility
1507 GLASTONBURY DR
SAINT JOHNS, MI 48879

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grace Haven Assisted Living LLC's NPI number?

The NPI number for Grace Haven Assisted Living LLC is 1053636167. It was assigned to this organization in the NPPES registry on March 31, 2010. The provider is doing business as Grace Haven Assisted Living - Laboratory.

Where is Grace Haven Assisted Living LLC located?

Grace Haven Assisted Living LLC is located at 1507 Glastonbury Dr, Saint Johns, MI 48879. The listed phone number is (989) 224-1650.

What is Grace Haven Assisted Living LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Grace Haven Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1102195) is associated with this NPI, valid through October 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grace Haven Assisted Living LLC was last updated on March 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.