23D2162811 CLIA NUMBER - SURGERY CENTER AT GATEWAY, LLC

Laboratory Demographics

  • CLIA Code: 23D2162811
  • Facility Name: SURGERY CENTER AT GATEWAY, LLC
  • Facility Address: 5302 GATEWAY CENTER
    FLINT, MI
    ZIP 48507
  • Facility Phone: 810 720-9111
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: EDWARD P. STACK
  • NPI Number: 1215400320
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2162811
LAB Type Ambulatory Surgery Center
Facility Name SURGERY CENTER AT GATEWAY, LLC
Street 5302 GATEWAY CENTER
City FLINT
State MI
ZIP 48507
Phone 810 720-9111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Ambulatory Surgery Center
Lab Director EDWARD P. STACK

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