10D2259544 CLIA NUMBER - PRIME DIALYSIS LLC

Laboratory Demographics

  • CLIA Code: 10D2259544
  • Facility Name: PRIME DIALYSIS LLC
  • Facility Address: 12200 WEST COLONIAL DRIVE
    WINTER GARDEN, FL
    ZIP 34787
  • Facility Phone: 954 709-9793
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: LETICIA ADAN
  • NPI Number: 1063941565
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2259544
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PRIME DIALYSIS LLC
Street 12200 WEST COLONIAL DRIVE
City WINTER GARDEN
State FL
ZIP 34787
Phone 954 709-9793
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2024
Certificate Expiration Date 5/5/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director LETICIA ADAN

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