23D2025652 CLIA NUMBER - PORTOLA DIALYSIS LLC DBA TOWN CENTER DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D2025652
  • Facility Name: PORTOLA DIALYSIS LLC DBA TOWN CENTER DIALYSIS
  • Facility Address: 323 N MICHIGAN AVENUE
    SAGINAW, MI
    ZIP 48602
  • Facility Phone: 989 791-3624
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SAYED M. OSAMA
  • NPI Number: 1841597689
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2025652
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PORTOLA DIALYSIS LLC DBA TOWN CENTER DIALYSIS
Street 323 N MICHIGAN AVENUE
City SAGINAW
State MI
ZIP 48602
Phone 989 791-3624
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2023
Certificate Expiration Date 6/13/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SAYED M. OSAMA

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This page was last updated on: 3/20/2025