36D2123245 CLIA NUMBER - MIRACLE MILE DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D2123245
  • Facility Name: MIRACLE MILE DIALYSIS
  • Facility Address: 4925 JACKMAN RD, UNIT #59
    TOLEDO, OH
    ZIP 43613
  • Facility Phone: 419 474-4989
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ANAND M. RAVINDRAN
  • NPI Number: 1396297537
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2123245
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MIRACLE MILE DIALYSIS
Street 4925 JACKMAN RD, UNIT #59
City TOLEDO
State OH
ZIP 43613
Phone 419 474-4989
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ANAND M. RAVINDRAN

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