23D1095645 CLIA NUMBER - WEST BLOOMFIELD DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D1095645
  • Facility Name: WEST BLOOMFIELD DIALYSIS
  • Facility Address: 6010 WEST MAPLE ROAD SUITE 215
    WEST BLOOMFIELD, MI
    ZIP 48322
  • Facility Phone: 248 539-1025
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: PITI RATANAPANICHKICH
  • NPI Number: 1619271871
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1095645
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WEST BLOOMFIELD DIALYSIS
Street 6010 WEST MAPLE ROAD SUITE 215
City WEST BLOOMFIELD
State MI
ZIP 48322
Phone 248 539-1025
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 PITI RATANAPANICHKICH

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