15D2015923 CLIA NUMBER - SCOTTSBURG DIALYSIS

Laboratory Demographics

  • CLIA Code: 15D2015923
  • Facility Name: SCOTTSBURG DIALYSIS
  • Facility Address: 1619 W MCCLAIN AVE
    SCOTTSBURG, IN
    ZIP 47170
  • Facility Phone: 812 752-5249
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MUAD A. MAYA
  • NPI Number: 1568778058
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2015923
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SCOTTSBURG DIALYSIS
Street 1619 W MCCLAIN AVE
City SCOTTSBURG
State IN
ZIP 47170
Phone 812 752-5249
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MUAD A. MAYA

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