23D1095644 CLIA NUMBER - ORCHARD SQUARE DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D1095644
  • Facility Name: ORCHARD SQUARE DIALYSIS
  • Facility Address: 1900 TELEGRAPH ROAD SUITE 200
    BLOOMFIELD HILLS, MI
    ZIP 48302
  • Facility Phone: 248 451-0954
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: GHADEER N. HANNOUDI
  • NPI Number: 1598912461
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1095644
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ORCHARD SQUARE DIALYSIS
Street 1900 TELEGRAPH ROAD SUITE 200
City BLOOMFIELD HILLS
State MI
ZIP 48302
Phone 248 451-0954
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director GHADEER N. HANNOUDI

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