24D1063968 CLIA NUMBER - ST PAUL CAPITOL DIALYSIS AT HOME

Laboratory Demographics

  • CLIA Code: 24D1063968
  • Facility Name: ST PAUL CAPITOL DIALYSIS AT HOME
  • Facility Address: 555 PARK STREET SUITE 110
    SAINT PAUL, MN
    ZIP 55103
  • Facility Phone: 651 221-3437
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: VISHAL SAGAR
  • NPI Number: 1538241443
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D1063968
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ST PAUL CAPITOL DIALYSIS AT HOME
Street 555 PARK STREET SUITE 110
City SAINT PAUL
State MN
ZIP 55103
Phone 651 221-3437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director VISHAL SAGAR

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