23D2160305 CLIA NUMBER - CHELSEA PROFESSIONAL BUILDING

Laboratory Demographics

  • CLIA Code: 23D2160305
  • Facility Name: CHELSEA PROFESSIONAL BUILDING
  • Facility Address: 14650 E OLD US 12
    CHELSEA, MI
    ZIP 48118
  • Facility Phone: 734 615-7902
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Microscopy
  • Lab Director: CASEY A. DAUW
  • NPI Number: 1689061426
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2160305
LAB Type Ambulatory Surgery Center
Facility Name CHELSEA PROFESSIONAL BUILDING
Street 14650 E OLD US 12
City CHELSEA
State MI
ZIP 48118
Phone 734 615-7902
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type Ambulatory Surgery Center
Lab Director CASEY A. DAUW

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