18D1061420 CLIA NUMBER - WEST BROADWAY DIALYSIS

Laboratory Demographics

  • CLIA Code: 18D1061420
  • Facility Name: WEST BROADWAY DIALYSIS
  • Facility Address: 720 WEST BROADWAY
    LOUISVILLE, KY
    ZIP 40202
  • Facility Phone: 502 584-2059
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: LESLIE G. WOOD
  • NPI Number: 1710079876
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D1061420
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WEST BROADWAY DIALYSIS
Street 720 WEST BROADWAY
City LOUISVILLE
State KY
ZIP 40202
Phone 502 584-2059
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2024
Certificate Expiration Date 11/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director LESLIE G. WOOD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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