23D0956757 CLIA NUMBER - PHYSICIAN'S DIALYSIS, INC GRAND HAVEN

Laboratory Demographics

  • CLIA Code: 23D0956757
  • Facility Name: PHYSICIAN'S DIALYSIS, INC GRAND HAVEN
  • Facility Address: 16964 ROBBINS ROAD SUITE 203
    GRAND HAVEN, MI
    ZIP 49417
  • Facility Phone: 616 847-2825
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JOSEPH P. MCKENNA
  • NPI Number: 1699736116
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0956757
LAB Type Other
Facility Name PHYSICIAN'S DIALYSIS, INC GRAND HAVEN
Street 16964 ROBBINS ROAD SUITE 203
City GRAND HAVEN
State MI
ZIP 49417
Phone 616 847-2825
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Other
Lab Director JOSEPH P. MCKENNA

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