23D1056248 CLIA NUMBER - RENAL CARE GROUP SOUTHWEST MICHIGAN LLC DBA FMC KALAMAZOO EAST

Laboratory Demographics

CLIA Number: 23D1056248

Facility Name: RENAL CARE GROUP SOUTHWEST MICHIGAN LLC DBA FMC KALAMAZOO EAST

Facility Address:
2901 E KILGORE ROAD ATTN KERSTIN KOENES
KALAMAZOO, MI
ZIP 49001
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Facility Phone Number: 269 345-1660

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1336163427

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D1056248
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RENAL CARE GROUP SOUTHWEST MICHIGAN LLC DBA FMC KALAMAZOO EAST
Street	2901 E KILGORE ROAD ATTN KERSTIN KOENES
City	KALAMAZOO
State	MI
ZIP	49001
Phone	269 345-1660
CertificateType	4
CertificateEffectiveDate	7/11/2022
CertificateExpirationDate	7/10/2024
FacilityType	Waiver

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