03D2047095 CLIA NUMBER - ESTRELLA MOUNTAIN DIALYSIS, LLC

Laboratory Demographics

  • CLIA Code: 03D2047095
  • Facility Name: ESTRELLA MOUNTAIN DIALYSIS, LLC
  • Facility Address: 9250 WEST THOMAS RD STE 120
    PHOENIX, AZ
    ZIP 85037
  • Facility Phone: 623 772-7363
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: WILLIAM L. WEISS
  • NPI Number: 1063767739
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2047095
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ESTRELLA MOUNTAIN DIALYSIS, LLC
Street 9250 WEST THOMAS RD STE 120
City PHOENIX
State AZ
ZIP 85037
Phone 623 772-7363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director WILLIAM L. WEISS

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