23D0909570 CLIA NUMBER - EASTSIDE ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 23D0909570
  • Facility Name: EASTSIDE ENDOSCOPY CENTER
  • Facility Address: 28963 LITTLE MACK STE 103
    ST CLAIR SHORES, MI
    ZIP 48081
  • Facility Phone: 586 447-5110
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SAMANTHA A. MILLER
  • NPI Number: 1407847676
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0909570
LAB Type Ambulatory Surgery Center
Facility Name EASTSIDE ENDOSCOPY CENTER
Street 28963 LITTLE MACK STE 103
City ST CLAIR SHORES
State MI
ZIP 48081
Phone 586 447-5110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2023
Certificate Expiration Date 12/10/2025
Facility Type Ambulatory Surgery Center
Lab Director SAMANTHA A. MILLER

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This page was last updated on: 9/29/2025