23D2119604 CLIA NUMBER - MID VALLEY PD HOME TRAINING

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Laboratory Demographics

CLIA Number: 23D2119604

Facility Name: MID VALLEY PD HOME TRAINING

Facility Address:
1205 N MICHIGAN AVENUE
SAGINAW, MI
ZIP 48602
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Facility Phone Number: 989 771-9381

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1861947020

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2119604
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	MID VALLEY PD HOME TRAINING
Street	1205 N MICHIGAN AVENUE
City	SAGINAW
State	MI
ZIP	48602
Phone	989 771-9381
CertificateType	4
CertificateEffectiveDate	9/29/2022
CertificateExpirationDate	9/28/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024