23D0363909 CLIA NUMBER - NORTHEAST SURGICAL GROUP PC

Laboratory Demographics

  • CLIA Code: 23D0363909
  • Facility Name: NORTHEAST SURGICAL GROUP PC
  • Facility Address: 17375 HALL ROAD
    MACOMB TOWNSHIP, MI
    ZIP 48044
  • Facility Phone: (810) 228-0550
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES H. MCQUISTON DO
  • NPI Number: 1700984200
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 23D0363909
LAB Type Physician Office
Facility Name NORTHEAST SURGICAL GROUP PC
Street 17375 HALL ROAD
City MACOMB TOWNSHIP
State MI
ZIP 48044
Phone 8102280550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JAMES H. MCQUISTON DO

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This page was last updated on: 5/18/2026