23D2080486 CLIA NUMBER - ROSCOMMON DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D2080486
  • Facility Name: ROSCOMMON DIALYSIS
  • Facility Address: 10450 N ROSCOMMON RD
    ROSCOMMON, MI
    ZIP 48653
  • Facility Phone: 989 275-0362
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CARLOS MARCHENA
  • NPI Number: 1831512003
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2080486
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ROSCOMMON DIALYSIS
Street 10450 N ROSCOMMON RD
City ROSCOMMON
State MI
ZIP 48653
Phone 989 275-0362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CARLOS MARCHENA

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