10D1079981 CLIA NUMBER - TREASURE COAST DIALYSIS

Laboratory Demographics

  • CLIA Code: 10D1079981
  • Facility Name: TREASURE COAST DIALYSIS
  • Facility Address: 1407 SOUTHEAST GOLDTREE DRIVE SUITE A
    PORT SAINT LUCIE, FL
    ZIP 34952
  • Facility Phone: 772 335-8672
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD IZHAR
  • NPI Number: 1346439387
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1079981
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TREASURE COAST DIALYSIS
Street 1407 SOUTHEAST GOLDTREE DRIVE SUITE A
City PORT SAINT LUCIE
State FL
ZIP 34952
Phone 772 335-8672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MOHAMMAD IZHAR

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