23D0865942 CLIA NUMBER - CENTRE FOR PLASTIC SURGERY

Laboratory Demographics

CLIA Number: 23D0865942

Facility Name: CENTRE FOR PLASTIC SURGERY

Facility Address:
2060 EAST PARIS, SE #150
GRAND RAPIDS, MI
ZIP 49546
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Facility Phone Number: 616 454-1256

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1184815417

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0865942
LAB Type	Ambulatory Surgery Center
Facility Name	CENTRE FOR PLASTIC SURGERY
Street	2060 EAST PARIS, SE #150
City	GRAND RAPIDS
State	MI
ZIP	49546
Phone	616 454-1256
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024