23D1062178 CLIA NUMBER - FENTON DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D1062178
  • Facility Name: FENTON DIALYSIS
  • Facility Address: 17420 SILVER PARKWAY
    FENTON, MI
    ZIP 48430
  • Facility Phone: 810 750-9200
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ALI KHAIR MOHAMMED
  • NPI Number: 1063517621
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1062178
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FENTON DIALYSIS
Street 17420 SILVER PARKWAY
City FENTON
State MI
ZIP 48430
Phone 810 750-9200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ALI KHAIR MOHAMMED

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