23D2121801 CLIA NUMBER - EYE SURGERY INSTITUTE

Laboratory Demographics

  • CLIA Code: 23D2121801
  • Facility Name: EYE SURGERY INSTITUTE
  • Facility Address: 15212 MICHIGAN AVENUE
    DEARBORN, MI
    ZIP 48126
  • Facility Phone: 313 582-8856
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STANLEY C. GRANDON
  • NPI Number: 1386711547
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 23D2121801
LAB Type Physician Office
Facility Name EYE SURGERY INSTITUTE
Street 15212 MICHIGAN AVENUE
City DEARBORN
State MI
ZIP 48126
Phone 313 582-8856
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director STANLEY C. GRANDON

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