03D0907134 CLIA NUMBER - ISD RENAL, INC DBA COTTONWOOD DIALYSIS

Laboratory Demographics

  • CLIA Code: 03D0907134
  • Facility Name: ISD RENAL, INC DBA COTTONWOOD DIALYSIS
  • Facility Address: 1699 E COTTONWOOD ST, STE A-200
    COTTONWOOD, AZ
    ZIP 86326
  • Facility Phone: 928 634-9295
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: WEI XIANG WONG
  • NPI Number: 1568417681
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D0907134
LAB Type Other
Facility Name ISD RENAL, INC DBA COTTONWOOD DIALYSIS
Street 1699 E COTTONWOOD ST, STE A-200
City COTTONWOOD
State AZ
ZIP 86326
Phone 928 634-9295
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Other
Lab Director WEI XIANG WONG

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