05D2084687 CLIA NUMBER - VISALIA VINEYARD DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2084687
  • Facility Name: VISALIA VINEYARD DIALYSIS
  • Facility Address: 1140 S BEN MADDOX WAY
    VISALIA, CA
    ZIP 93292
  • Facility Phone: 559 635-1938
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SREEDHAR ADAPA
  • NPI Number: 1386069367
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2084687
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name VISALIA VINEYARD DIALYSIS
Street 1140 S BEN MADDOX WAY
City VISALIA
State CA
ZIP 93292
Phone 559 635-1938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SREEDHAR ADAPA

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