23D0865942 CLIA NUMBER - CENTRE FOR PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 23D0865942
  • Facility Name: CENTRE FOR PLASTIC SURGERY
  • Facility Address: 2060 EAST PARIS, SE #150
    GRAND RAPIDS, MI
    ZIP 49546
  • Facility Phone: (616) 454-1256
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PATTY BAKKER
  • NPI Number: 1184815417
  • Taxonomy: 261QA1903X - Clinic/Center

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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 6164541256
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 Ambulatory Surgery Center
Lab Director PATTY BAKKER

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This page was last updated on: 5/15/2026