23D2274954 CLIA NUMBER - MICHIGAN SPECIALTY SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 23D2274954
  • Facility Name: MICHIGAN SPECIALTY SURGERY CENTER, LLC
  • Facility Address: 6886 SASHABAW ROAD
    CLARKSTON, MI
    ZIP 48348
  • Facility Phone: 248 707-3112
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AMIR KIANOOSH M. FALLAHI
  • NPI Number: 1558072629
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2274954
LAB Type Ambulatory Surgery Center
Facility Name MICHIGAN SPECIALTY SURGERY CENTER, LLC
Street 6886 SASHABAW ROAD
City CLARKSTON
State MI
ZIP 48348
Phone 248 707-3112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Ambulatory Surgery Center
Lab Director AMIR KIANOOSH M. FALLAHI

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