23D2329171 CLIA NUMBER - COOLIDGE ROYAL OAK, LLC

Laboratory Demographics

  • CLIA Code: 23D2329171
  • Facility Name: COOLIDGE ROYAL OAK, LLC
  • Facility Address: 5140 COOLIDGE HIGHWAY
    ROYAL OAK, MI
    ZIP 48073
  • Facility Phone: 586 260-4665
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SAMANTHA M. LARSON
  • NPI Number: 1215813399
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2329171
LAB Type Ambulatory Surgery Center
Facility Name COOLIDGE ROYAL OAK, LLC
Street 5140 COOLIDGE HIGHWAY
City ROYAL OAK
State MI
ZIP 48073
Phone 586 260-4665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Ambulatory Surgery Center
Lab Director SAMANTHA M. LARSON

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