23D2099951 CLIA NUMBER - PARTRIDGE CREEK DIALYSIS

Laboratory Demographics

  • CLIA Code: 23D2099951
  • Facility Name: PARTRIDGE CREEK DIALYSIS
  • Facility Address: 46360 GRATIOT AVENUE
    CHESTERFIELD, MI
    ZIP 48051
  • Facility Phone: 586 949-5417
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER R. PROVENZANO
  • NPI Number: 1306239140
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2099951
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PARTRIDGE CREEK DIALYSIS
Street 46360 GRATIOT AVENUE
City CHESTERFIELD
State MI
ZIP 48051
Phone 586 949-5417
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CHRISTOPHER R. PROVENZANO

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