24D0928604 CLIA NUMBER - RIVER CITY DIALYSIS

Laboratory Demographics

  • CLIA Code: 24D0928604
  • Facility Name: RIVER CITY DIALYSIS
  • Facility Address: 1970 NORTHWESTERN AVENUE NORTH
    STILLWATER, MN
    ZIP 55082
  • Facility Phone: 651 430-0067
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JUDSON POLLECK
  • NPI Number: 1558325910
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D0928604
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RIVER CITY DIALYSIS
Street 1970 NORTHWESTERN AVENUE NORTH
City STILLWATER
State MN
ZIP 55082
Phone 651 430-0067
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JUDSON POLLECK

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