04D2130967 CLIA NUMBER - DIAMOND STATE DIALYSIS

Laboratory Demographics

  • CLIA Code: 04D2130967
  • Facility Name: DIAMOND STATE DIALYSIS
  • Facility Address: 9022 LANDERS ROAD, STE E
    NORTH LITTLE ROCK, AR
    ZIP 72117
  • Facility Phone: 501 834-1393
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. VIKAS VUJJINI
  • NPI Number: 1588102610
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2130967
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIAMOND STATE DIALYSIS
Street 9022 LANDERS ROAD, STE E
City NORTH LITTLE ROCK
State AR
ZIP 72117
Phone 501 834-1393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. VIKAS VUJJINI

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