15D2059749 CLIA NUMBER - SOUTH BEND WEST DIALYSIS

Laboratory Demographics

  • CLIA Code: 15D2059749
  • Facility Name: SOUTH BEND WEST DIALYSIS
  • Facility Address: 5660 NIMTZ PKWY
    SOUTH BEND, IN
    ZIP 46628
  • Facility Phone: 574 231-7570
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: LESLIE A. SCHMITZ
  • NPI Number: 1528477031
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 15D2059749
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTH BEND WEST DIALYSIS
Street 5660 NIMTZ PKWY
City SOUTH BEND
State IN
ZIP 46628
Phone 574 231-7570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director LESLIE A. SCHMITZ

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This page was last updated on: 6/4/2025