23D2051734 CLIA NUMBER - LIBERTY DIALYSIS AT LAKELAND BENTON HARBOR

Laboratory Demographics

  • CLIA Code: 23D2051734
  • Facility Name: LIBERTY DIALYSIS AT LAKELAND BENTON HARBOR
  • Facility Address: 338 8TH STREET
    BENTON HARBOR, MI
    ZIP 49022
  • Facility Phone: 269 605-0135
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: TARA E. HUNSBERGER
  • NPI Number: 1407150279
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2051734
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LIBERTY DIALYSIS AT LAKELAND BENTON HARBOR
Street 338 8TH STREET
City BENTON HARBOR
State MI
ZIP 49022
Phone 269 605-0135
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2024
Certificate Expiration Date 12/26/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director TARA E. HUNSBERGER

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