23D1009657 CLIA NUMBER - GASTROINTESTINAL ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 23D1009657
  • Facility Name: GASTROINTESTINAL ENDOSCOPY CENTER
  • Facility Address: 264 W MAPLE ROAD SUITE 100
    TROY, MI
    ZIP 48084
  • Facility Phone: 248 269-5594
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL E. CANNON
  • NPI Number: 1104899855
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1009657
LAB Type Ambulatory Surgery Center
Facility Name GASTROINTESTINAL ENDOSCOPY CENTER
Street 264 W MAPLE ROAD SUITE 100
City TROY
State MI
ZIP 48084
Phone 248 269-5594
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL E. CANNON

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