23D2035548 CLIA NUMBER - BEACHSIDE DIALYSIS, LLC DBA HARPER WOODS DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D2035548
  • Facility Name: BEACHSIDE DIALYSIS, LLC DBA HARPER WOODS DIALYSIS
  • Facility Address: 19265 VERNIER ROAD
    HARPER WOODS, MI
    ZIP 48225
  • Facility Phone: 313 640-0271
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KEITH A. BELLOVICH
  • NPI Number: 1780953604
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2035548
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BEACHSIDE DIALYSIS, LLC DBA HARPER WOODS DIALYSIS
Street 19265 VERNIER ROAD
City HARPER WOODS
State MI
ZIP 48225
Phone 313 640-0271
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KEITH A. BELLOVICH

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