15D2040322 CLIA NUMBER - SUMMIT CITY DIALYSIS

Laboratory Demographics

  • CLIA Code: 15D2040322
  • Facility Name: SUMMIT CITY DIALYSIS
  • Facility Address: 3233 E COLISEUM BLVD
    FORT WAYNE, IN
    ZIP 46805
  • Facility Phone: 260 373-1599
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: IRFAN MUNIR
  • NPI Number: 1558635276
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2040322
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SUMMIT CITY DIALYSIS
Street 3233 E COLISEUM BLVD
City FORT WAYNE
State IN
ZIP 46805
Phone 260 373-1599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director IRFAN MUNIR

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