17D1072272 CLIA NUMBER - MAIZE DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 17D1072272
  • Facility Name: MAIZE DIALYSIS CENTER
  • Facility Address: 10001 W GRADY AVENUE
    MAIZE, KS
    ZIP 67101
  • Facility Phone: 316 773-1400
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MOHAMAD SANDID
  • NPI Number: 1639379324
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D1072272
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MAIZE DIALYSIS CENTER
Street 10001 W GRADY AVENUE
City MAIZE
State KS
ZIP 67101
Phone 316 773-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2025
Certificate Expiration Date 8/12/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MOHAMAD SANDID

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