10D2228830 CLIA NUMBER - ARA SOUTHSIDE DIALYSIS, LLC

Laboratory Demographics

  • CLIA Code: 10D2228830
  • Facility Name: ARA SOUTHSIDE DIALYSIS, LLC
  • Facility Address: 12735 GRAN BAY PKWY W STE 210
    JACKSONVILLE, FL
    ZIP 32258
  • Facility Phone: 904 659-6999
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAMESH KOTIHAL
  • NPI Number: 1720662489
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2228830
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ARA SOUTHSIDE DIALYSIS, LLC
Street 12735 GRAN BAY PKWY W STE 210
City JACKSONVILLE
State FL
ZIP 32258
Phone 904 659-6999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAMESH KOTIHAL

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