24D2059969 CLIA NUMBER - EAST VALLEY DIALYSIS

Laboratory Demographics

  • CLIA Code: 24D2059969
  • Facility Name: EAST VALLEY DIALYSIS
  • Facility Address: 14050 PILOT KNOB ROAD SUITE 100
    APPLE VALLEY, MN
    ZIP 55124
  • Facility Phone: 952 423-4062
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JAMES SOMERVILLE
  • NPI Number: 1083059299
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2059969
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EAST VALLEY DIALYSIS
Street 14050 PILOT KNOB ROAD SUITE 100
City APPLE VALLEY
State MN
ZIP 55124
Phone 952 423-4062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2025
Certificate Expiration Date 6/3/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JAMES SOMERVILLE

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