14D2116934 CLIA NUMBER - HOME DIALYSIS SERVICES OLYMPIA FIELDS, L L C

Laboratory Demographics

  • CLIA Code: 14D2116934
  • Facility Name: HOME DIALYSIS SERVICES OLYMPIA FIELDS, L L C
  • Facility Address: 3322 VOLLMER RD
    OLYMPIA FIELDS, IL
    ZIP 60461
  • Facility Phone: 708 898-1245
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SURESH SAMSON MD
  • NPI Number: 1356782288
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2116934
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name HOME DIALYSIS SERVICES OLYMPIA FIELDS, L L C
Street 3322 VOLLMER RD
City OLYMPIA FIELDS
State IL
ZIP 60461
Phone 708 898-1245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SURESH SAMSON MD

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