23D2218739 CLIA NUMBER - ADVANCED PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 23D2218739
  • Facility Name: ADVANCED PLASTIC SURGERY
  • Facility Address: 3855 BURTON STREET SE SUITE A
    GRAND RAPIDS, MI
    ZIP 49546
  • Facility Phone: 616 323-3102
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: EWA KOMOROWSKA-TIMEK
  • NPI Number: 1497425508
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2218739
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED PLASTIC SURGERY
Street 3855 BURTON STREET SE SUITE A
City GRAND RAPIDS
State MI
ZIP 49546
Phone 616 323-3102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Ambulatory Surgery Center
Lab Director EWA KOMOROWSKA-TIMEK

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