23D1076434 CLIA NUMBER - CLINTON TOWNSHIP DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D1076434
  • Facility Name: CLINTON TOWNSHIP DIALYSIS
  • Facility Address: 15918 19 MILE ROAD, STE 110
    CLINTON TOWNSHIP, MI
    ZIP 48038
  • Facility Phone: 586 412-9195
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JUKAKU TAYEB
  • NPI Number: 1013101310
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1076434
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CLINTON TOWNSHIP DIALYSIS
Street 15918 19 MILE ROAD, STE 110
City CLINTON TOWNSHIP
State MI
ZIP 48038
Phone 586 412-9195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JUKAKU TAYEB

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