05D0928517 CLIA NUMBER - LODI DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 05D0928517
  • Facility Name: LODI DIALYSIS CENTER
  • Facility Address: 1610 W KETTLEMAN LANE, SUITE D
    LODI, CA
    ZIP 95242
  • Facility Phone: 209 334-9888
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: VISHWA SHETH
  • NPI Number: 1528027349
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0928517
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LODI DIALYSIS CENTER
Street 1610 W KETTLEMAN LANE, SUITE D
City LODI
State CA
ZIP 95242
Phone 209 334-9888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director VISHWA SHETH

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