15D2029070 CLIA NUMBER - PAOLI DIALYSIS

Laboratory Demographics

  • CLIA Code: 15D2029070
  • Facility Name: PAOLI DIALYSIS
  • Facility Address: 555 W LONGEST ST
    PAOLI, IN
    ZIP 47454
  • Facility Phone: 812 723-3571
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: HIDEKI KAWANISHI
  • NPI Number: 1538457809
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2029070
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PAOLI DIALYSIS
Street 555 W LONGEST ST
City PAOLI
State IN
ZIP 47454
Phone 812 723-3571
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director HIDEKI KAWANISHI

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