23D2307802 CLIA NUMBER - THIRD COAST ORAL & MAXILLOFACIAL SURGERY

Laboratory Demographics

  • CLIA Code: 23D2307802
  • Facility Name: THIRD COAST ORAL & MAXILLOFACIAL SURGERY
  • Facility Address: 2119 64TH STREET SW
    BYRON CENTER, MI
    ZIP 49315
  • Facility Phone: 616 217-3632
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER C. NIQUETTE
  • NPI Number: 1902551351
  • Taxonomy: 261QS0112X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D2307802
LAB Type Independent
Facility Name THIRD COAST ORAL & MAXILLOFACIAL SURGERY
Street 2119 64TH STREET SW
City BYRON CENTER
State MI
ZIP 49315
Phone 616 217-3632
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Independent
Lab Director CHRISTOPHER C. NIQUETTE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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