14D2057818 CLIA NUMBER - MOLINE HOME TRAINING

Laboratory Demographics

  • CLIA Code: 14D2057818
  • Facility Name: MOLINE HOME TRAINING
  • Facility Address: 4650 38TH AVE
    MOLINE, IL
    ZIP 61265
  • Facility Phone: 309 736-4255
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAJENDRA DAHAL
  • NPI Number: 1982940664
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2057818
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MOLINE HOME TRAINING
Street 4650 38TH AVE
City MOLINE
State IL
ZIP 61265
Phone 309 736-4255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2025
Certificate Expiration Date 4/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAJENDRA DAHAL

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