10D1100116 CLIA NUMBER - WESLEY CHAPEL DIALYSIS

Laboratory Demographics

  • CLIA Code: 10D1100116
  • Facility Name: WESLEY CHAPEL DIALYSIS
  • Facility Address: 2255 GREEN HEDGES WAY
    WESLEY CHAPEL, FL
    ZIP 33544
  • Facility Phone: 813 973-0153
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ALEJANDRO E. CARVALLO
  • NPI Number: 1659514040
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1100116
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WESLEY CHAPEL DIALYSIS
Street 2255 GREEN HEDGES WAY
City WESLEY CHAPEL
State FL
ZIP 33544
Phone 813 973-0153
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2025
Certificate Expiration Date 5/28/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ALEJANDRO E. CARVALLO

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