HAGGERTY ROAD OPCO LLC
NPI 1386432946
Skilled Nursing Facility in Plymouth, MI
About Haggerty Road Opco Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HAGGERTY ROAD OPCO LLC (NPI 1386432946), doing business as Medilodge Of Haggerty Road, is a healthcare organization registered as a skilled nursing facility in Plymouth, Michigan and active in the NPI registry since April 2025. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Kristine Ranel Kirk, Delegated Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Other Names 1
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0680953
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- TINA LONG
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Haggerty Road Opco Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386432946, enumerated as an "organization" on April 25, 2025.
The provider is located at 105 N HAGGERTY RD PLYMOUTH, MI 48170 and the phone number is (734) 455-0510.
Skilled Nursing Facility with taxonomy code 314000000X.
