23D2109284 CLIA NUMBER - SUSAN S MAPLES DDS

Laboratory Demographics

  • CLIA Code: 23D2109284
  • Facility Name: SUSAN S MAPLES DDS
  • Facility Address: 2101 N AURELIUS ROAD SUITE 1
    HOLT, MI
    ZIP 48842
  • Facility Phone: 517 694-0353
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SUSAN S. MAPLES
  • NPI Number: 1932298106
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 23D2109284
LAB Type Practitioner Other
Facility Name SUSAN S MAPLES DDS
Street 2101 N AURELIUS ROAD SUITE 1
City HOLT
State MI
ZIP 48842
Phone 517 694-0353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Practitioner Other
Lab Director SUSAN S. MAPLES

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