26D2049043 CLIA NUMBER - SOUTH CITY DIALYSIS

Laboratory Demographics

  • CLIA Code: 26D2049043
  • Facility Name: SOUTH CITY DIALYSIS
  • Facility Address: 3740 SOUTH JEFFERSON AVENUE
    SAINT LOUIS, MO
    ZIP 63118
  • Facility Phone: 314 664-6687
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: NABIL HANNA TAUK
  • NPI Number: 1245580570
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2049043
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTH CITY DIALYSIS
Street 3740 SOUTH JEFFERSON AVENUE
City SAINT LOUIS
State MO
ZIP 63118
Phone 314 664-6687
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director NABIL HANNA TAUK

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