23D0897331 CLIA NUMBER - SOUTHGATE DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D0897331
  • Facility Name: SOUTHGATE DIALYSIS
  • Facility Address: 14752 NORTHLINE ROAD
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: 313 284-0005
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: C V KUMAR MD
  • NPI Number: 1689046070
  • Taxonomy: 367H00000X - Anesthesiologist Assistant

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CLIA Record

Field Name Field Value
CLIA Number 23D0897331
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTHGATE DIALYSIS
Street 14752 NORTHLINE ROAD
City SOUTHGATE
State MI
ZIP 48195
Phone 313 284-0005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director C V KUMAR MD

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