23D2104575 CLIA NUMBER - RED CEDAR SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 23D2104575

Facility Name: RED CEDAR SURGERY CENTER, LLC

Facility Address:
5668 OKEMOS ROAD
HASLETT, MI
ZIP 48840
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Facility Phone Number: 517 896-6760

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1104298009

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2104575
LAB Type	Ambulatory Surgery Center
Facility Name	RED CEDAR SURGERY CENTER, LLC
Street	5668 OKEMOS ROAD
City	HASLETT
State	MI
ZIP	48840
Phone	517 896-6760
CertificateType	4
CertificateEffectiveDate	11/9/2023
CertificateExpirationDate	11/8/2025
FacilityType	Waiver

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