24D1075109 CLIA NUMBER - EAST RIVER ROAD DIALYSIS

Laboratory Demographics

  • CLIA Code: 24D1075109
  • Facility Name: EAST RIVER ROAD DIALYSIS
  • Facility Address: 5301 E RIVER ROAD SUITE 117
    FRIDLEY, MN
    ZIP 55421
  • Facility Phone: 763 571-5556
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KEITH E. ELDMAN
  • NPI Number: 1740487057
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D1075109
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EAST RIVER ROAD DIALYSIS
Street 5301 E RIVER ROAD SUITE 117
City FRIDLEY
State MN
ZIP 55421
Phone 763 571-5556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KEITH E. ELDMAN

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