22D1103727 CLIA NUMBER - HERITAGE DIALYSIS CENTER LLC

Laboratory Demographics

  • CLIA Code: 22D1103727
  • Facility Name: HERITAGE DIALYSIS CENTER LLC
  • Facility Address: 67 COOPER STREET
    AGAWAM, MA
    ZIP 01001
  • Facility Phone: 413 786-2022
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JONATHAN SLATER
  • NPI Number: 1699913376
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 22D1103727
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name HERITAGE DIALYSIS CENTER LLC
Street 67 COOPER STREET
City AGAWAM
State MA
ZIP 01001
Phone 413 786-2022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JONATHAN SLATER

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