17D2104125 CLIA NUMBER - NOTTINGHAM DIALYSIS

Laboratory Demographics

  • CLIA Code: 17D2104125
  • Facility Name: NOTTINGHAM DIALYSIS
  • Facility Address: 14010 W 134TH PLACE ATTN LICENSURE & CERTIFICATION
    OLATHE, KS
    ZIP 66062
  • Facility Phone: 913 764-0358
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SULEIMAN DAIFALLAH
  • NPI Number: 1538538673
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2104125
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NOTTINGHAM DIALYSIS
Street 14010 W 134TH PLACE ATTN LICENSURE & CERTIFICATION
City OLATHE
State KS
ZIP 66062
Phone 913 764-0358
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SULEIMAN DAIFALLAH

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