DEARBORN HOME DIALYSIS
NPI 1619386489
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Dearborn, MI

Active since August 06, 2014CLIA 23D1080304 · Waiver
22030 PARK ST, DEARBORN, MI 48124(313) 792-7343(313) 792-8341 Get Directions Write a Review

NPPES record last updated: August 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 1, 2024, Feb 9, 2021, Jan 28, 2019 and 1 more (4 updates tracked since 2019).

About Dearborn Home Dialysis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEARBORN HOME DIALYSIS (NPI 1619386489) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Dearborn, Michigan and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through February 19, 2028 and lists Samuel T Wey, Vp, Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1619386489
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameLASSEN DIALYSIS, LLC
Location Address22030 PARK STDearborn, MI 48124-2854
Mailing Address5200 Virginia Way, Att: L&c DeptBrentwood, TN 37027-7569
Fax(313) 792-8341
Organization SubpartNo
Authorized OfficialSamuel T WeyVp, Licensure & Certification · (615) 341-6641
Enumeration DateAugust 6, 2014
Last NPPES UpdateAugust 1, 20244 updates tracked since enumeration
NPPES CertifiedAugust 1, 2024
NPI 1619386489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
22030 PARK ST, Dearborn, MI 48124

Other Names 1

Doing Business AsDearborn Home Dialysis

Other Identifiers 1

Medicaid1619686489MI

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1080304

Dearborn Home Dialysis · Dearborn, MI
Active · expires Feb 19, 2028
CLIA Number23D1080304
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateFebruary 20, 2026
Certificate Expiration DateFebruary 19, 2028
Laboratory DirectorKrishnapillai Thavarajah
Laboratory Phone(615) 341-6793
Laboratory LocationDearborn Home Dialysis22030 Park Street, Dearborn, MI 48124
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Nephrology)
22030 PARK ST, STE 103
DEARBORN, MI 48124
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
22030 PARK ST
DEARBORN, MI 48124

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lassen Dialysis, LLC's NPI number?

The NPI number for Lassen Dialysis, LLC is 1619386489. It was assigned to this organization in the NPPES registry on August 6, 2014. The provider is doing business as Dearborn Home Dialysis.

Where is Lassen Dialysis, LLC located?

Lassen Dialysis, LLC is located at 22030 Park St, Dearborn, MI 48124. The listed phone number is (313) 792-7343.

What is Lassen Dialysis, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Lassen Dialysis, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1080304) is associated with this NPI, valid through February 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lassen Dialysis, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 9 other insurers list Lassen Dialysis, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lassen Dialysis, LLC was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.