17D0676251 CLIA NUMBER - INDEPENDENCE DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 17D0676251
  • Facility Name: INDEPENDENCE DIALYSIS CENTER
  • Facility Address: 801 WEST MYRTLE
    INDEPENDENCE, KS
    ZIP 67301
  • Facility Phone: 620 331-4020
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: USHA CHALLA
  • NPI Number: 1104598721
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D0676251
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name INDEPENDENCE DIALYSIS CENTER
Street 801 WEST MYRTLE
City INDEPENDENCE
State KS
ZIP 67301
Phone 620 331-4020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director USHA CHALLA

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