23D1022231 CLIA NUMBER - UNA SOURCE SURGERY CENTER

Laboratory Demographics

CLIA Number: 23D1022231

Facility Name: UNA SOURCE SURGERY CENTER

Facility Address:
4550 INVESTMENT DRIVE SUITE 100
TROY, MI
ZIP 48098
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Facility Phone Number: 248 265-4600

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1649219536

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D1022231
LAB Type	Ambulatory Surgery Center
Facility Name	UNA SOURCE SURGERY CENTER
Street	4550 INVESTMENT DRIVE SUITE 100
City	TROY
State	MI
ZIP	48098
Phone	248 265-4600
CertificateType	4
CertificateEffectiveDate	3/1/2023
CertificateExpirationDate	2/28/2025
FacilityType	Waiver

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