23D2217788 CLIA NUMBER - GRAND RIVER SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 23D2217788
  • Facility Name: GRAND RIVER SURGERY CENTER, LLC
  • Facility Address: 1090 TROWBRIDGE ROAD SUITE A
    EAST LANSING, MI
    ZIP 48823
  • Facility Phone: 517 282-0851
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AHMED SUFYAN
  • NPI Number: 1124605910
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2217788
LAB Type Ambulatory Surgery Center
Facility Name GRAND RIVER SURGERY CENTER, LLC
Street 1090 TROWBRIDGE ROAD SUITE A
City EAST LANSING
State MI
ZIP 48823
Phone 517 282-0851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Ambulatory Surgery Center
Lab Director AHMED SUFYAN

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