23D2012091 CLIA NUMBER - BEAUMONT KIDNEY SPECIALTY SERVICES LLC

Laboratory Demographics

  • CLIA Code: 23D2012091
  • Facility Name: BEAUMONT KIDNEY SPECIALTY SERVICES LLC
  • Facility Address: 26400 W 12 MILE ROAD
    SOUTHFIELD, MI
    ZIP 48034
  • Facility Phone: 248 228-8777
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DEBORAH COUNTS
  • NPI Number: 1669703799
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2012091
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BEAUMONT KIDNEY SPECIALTY SERVICES LLC
Street 26400 W 12 MILE ROAD
City SOUTHFIELD
State MI
ZIP 48034
Phone 248 228-8777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DEBORAH COUNTS

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