23D1025862 CLIA NUMBER - EAST PARIS SURGICAL CENTER

Laboratory Demographics

CLIA Number: 23D1025862

Facility Name: EAST PARIS SURGICAL CENTER

Facility Address:
1000 E PARIS AVENUE SE SUITE LL01
GRAND RAPIDS, MI
ZIP 49546
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Facility Phone Number: 616 464-3430

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1194798959

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D1025862
LAB Type	Ambulatory Surgery Center
Facility Name	EAST PARIS SURGICAL CENTER
Street	1000 E PARIS AVENUE SE SUITE LL01
City	GRAND RAPIDS
State	MI
ZIP	49546
Phone	616 464-3430
CertificateType	4
CertificateEffectiveDate	5/20/2022
CertificateExpirationDate	5/19/2024
FacilityType	Waiver

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