23D2298727 CLIA NUMBER - MICHIGAN KIDNEY CONSULTANTS

Laboratory Demographics

CLIA Number: 23D2298727

Facility Name: MICHIGAN KIDNEY CONSULTANTS

Facility Address:
26850 PROVIDENCE PARKWAY SUITE 325
NOVI, MI
ZIP 48375
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Facility Phone Number: 248 348-9000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1467623769

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	23D2298727
LAB Type	Physician Office
Facility Name	MICHIGAN KIDNEY CONSULTANTS
Street	26850 PROVIDENCE PARKWAY SUITE 325
City	NOVI
State	MI
ZIP	48375
Phone	248 348-9000
CertificateType	4
CertificateEffectiveDate	2/7/2024
CertificateExpirationDate	2/6/2026
FacilityType	Waiver

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