16D2053953 CLIA NUMBER - OTTUMWA DIALYSIS

Laboratory Demographics

  • CLIA Code: 16D2053953
  • Facility Name: OTTUMWA DIALYSIS
  • Facility Address: 1005 PENNSYLVANIA AVENUE, SUITE 101
    OTTUMWA, IA
    ZIP 52501
  • Facility Phone: 641 682-1531
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JASHIM U. AHMED
  • NPI Number: 1649517673
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D2053953
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name OTTUMWA DIALYSIS
Street 1005 PENNSYLVANIA AVENUE, SUITE 101
City OTTUMWA
State IA
ZIP 52501
Phone 641 682-1531
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2025
Certificate Expiration Date 2/10/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JASHIM U. AHMED

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