36D2087047 CLIA NUMBER - MIDWEST SURGICAL CENTER

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Laboratory Demographics

CLIA Number: 36D2087047

Facility Name: MIDWEST SURGICAL CENTER

Facility Address:
7100 ORCHARD CENTRE DR
HOLLAND, OH
ZIP 43528
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Facility Phone Number: 419 866-2000

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1154738508

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2087047
LAB Type	Ambulatory Surgery Center
Facility Name	MIDWEST SURGICAL CENTER
Street	7100 ORCHARD CENTRE DR
City	HOLLAND
State	OH
ZIP	43528
Phone	419 866-2000
CertificateType	4
CertificateEffectiveDate	11/17/2022
CertificateExpirationDate	11/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024