14D2047370 CLIA NUMBER - SHILOH DIALYSIS (DBA) TOTAL RENAL CARE INC

Laboratory Demographics

  • CLIA Code: 14D2047370
  • Facility Name: SHILOH DIALYSIS (DBA) TOTAL RENAL CARE INC
  • Facility Address: 1095 N GREEN MOUNT RD
    BELLEVILLE, IL
    ZIP 62221
  • Facility Phone: 618 628-1108
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RASHID A. DALAL
  • NPI Number: 1871848895
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2047370
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SHILOH DIALYSIS (DBA) TOTAL RENAL CARE INC
Street 1095 N GREEN MOUNT RD
City BELLEVILLE
State IL
ZIP 62221
Phone 618 628-1108
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RASHID A. DALAL

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