23D0978667 CLIA NUMBER - FMC DIALYSIS SERVICE BEWICK

Laboratory Demographics

  • CLIA Code: 23D0978667
  • Facility Name: FMC DIALYSIS SERVICE BEWICK
  • Facility Address: 7733 E JEFFERSON AVENUE SUITE 120
    DETROIT, MI
    ZIP 48214
  • Facility Phone: 313 824-3430
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CAROLYN WILKERSON
  • NPI Number: 1043325889
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0978667
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FMC DIALYSIS SERVICE BEWICK
Street 7733 E JEFFERSON AVENUE SUITE 120
City DETROIT
State MI
ZIP 48214
Phone 313 824-3430
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CAROLYN WILKERSON

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This page was last updated on: 6/4/2025