23D2028891 CLIA NUMBER - BLANCO DIALYSIS LLC DBA APPLE AVENUE DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D2028891
  • Facility Name: BLANCO DIALYSIS LLC DBA APPLE AVENUE DIALYSIS
  • Facility Address: 2480 E APPLE AVENUE UNIT E
    MUSKEGON, MI
    ZIP 49442
  • Facility Phone: 231 773-0597
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BAO MIN TWU
  • NPI Number: 1407143712
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2028891
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BLANCO DIALYSIS LLC DBA APPLE AVENUE DIALYSIS
Street 2480 E APPLE AVENUE UNIT E
City MUSKEGON
State MI
ZIP 49442
Phone 231 773-0597
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BAO MIN TWU

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