10D2289463 CLIA NUMBER - BIG BEND DIALYSIS

Laboratory Demographics

  • CLIA Code: 10D2289463
  • Facility Name: BIG BEND DIALYSIS
  • Facility Address: 6611 SIMMONS LOOP
    RIVERVIEW, FL
    ZIP 33578
  • Facility Phone: 656 218-3901
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHYAM J. UTTAMCHANDANI
  • NPI Number: 1366130700
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2289463
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BIG BEND DIALYSIS
Street 6611 SIMMONS LOOP
City RIVERVIEW
State FL
ZIP 33578
Phone 656 218-3901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHYAM J. UTTAMCHANDANI

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