23D2016752 CLIA NUMBER - STATE FAIR DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D2016752
  • Facility Name: STATE FAIR DIALYSIS
  • Facility Address: 19800 WOODWARD AVE
    DETROIT, MI
    ZIP 48203
  • Facility Phone: 313 893-8610
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: XIAOPING HUANG
  • NPI Number: 1538265335
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2016752
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name STATE FAIR DIALYSIS
Street 19800 WOODWARD AVE
City DETROIT
State MI
ZIP 48203
Phone 313 893-8610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director XIAOPING HUANG

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