23D2072600 CLIA NUMBER - DEARBORN KIDNEY CENTER

Laboratory Demographics

  • CLIA Code: 23D2072600
  • Facility Name: DEARBORN KIDNEY CENTER
  • Facility Address: 5111 AUTO CLUB DRIVE BLDG B, STE 120
    DEARBORN, MI
    ZIP 48126
  • Facility Phone: 313 982-9788
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RABIH M. BAZZI
  • NPI Number: 1356783724
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2072600
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DEARBORN KIDNEY CENTER
Street 5111 AUTO CLUB DRIVE BLDG B, STE 120
City DEARBORN
State MI
ZIP 48126
Phone 313 982-9788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RABIH M. BAZZI

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