23D2011143 CLIA NUMBER - ROYAL OAK SURGICAL CENTER

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Laboratory Demographics

CLIA Number: 23D2011143

Facility Name: ROYAL OAK SURGICAL CENTER

Facility Address:
5130 COOLIDGE HWY SUITE 120
ROYAL OAK, MI
ZIP 48073
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Facility Phone Number: 248 658-0878

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1073818654

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2011143
LAB Type	Ambulatory Surgery Center
Facility Name	ROYAL OAK SURGICAL CENTER
Street	5130 COOLIDGE HWY SUITE 120
City	ROYAL OAK
State	MI
ZIP	48073
Phone	248 658-0878
CertificateType	4
CertificateEffectiveDate	5/7/2024
CertificateExpirationDate	5/6/2026
FacilityType	Waiver

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