10D2082304 CLIA NUMBER - COLUMBIA COUNTY DIALYSIS

Laboratory Demographics

  • CLIA Code: 10D2082304
  • Facility Name: COLUMBIA COUNTY DIALYSIS
  • Facility Address: 1389 W US HWY 90 STE 100
    LAKE CITY, FL
    ZIP 32055
  • Facility Phone: 386 466-0197
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BROOKE MOBLEY
  • NPI Number: 1295154912
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2082304
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name COLUMBIA COUNTY DIALYSIS
Street 1389 W US HWY 90 STE 100
City LAKE CITY
State FL
ZIP 32055
Phone 386 466-0197
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BROOKE MOBLEY

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