10D0864369 CLIA NUMBER - NORTHEAST FLORIDA DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 10D0864369
  • Facility Name: NORTHEAST FLORIDA DIALYSIS CENTER
  • Facility Address: 2141 LOCH RANE BLVD STE 112 & 115
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 272-7331
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAMESH D. KOTIHAL
  • NPI Number: 1033135306
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0864369
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NORTHEAST FLORIDA DIALYSIS CENTER
Street 2141 LOCH RANE BLVD STE 112 & 115
City ORANGE PARK
State FL
ZIP 32073
Phone 904 272-7331
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAMESH D. KOTIHAL

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