26D2121796 CLIA NUMBER - DIALYSIS CLINIC INC FULTON

Laboratory Demographics

  • CLIA Code: 26D2121796
  • Facility Name: DIALYSIS CLINIC INC FULTON
  • Facility Address: 2613 FAIRWAY DRIVE E
    FULTON, MO
    ZIP 65251
  • Facility Phone: 573 592-1964
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MADHUKER MISRA
  • NPI Number: 1801241294
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2121796
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS CLINIC INC FULTON
Street 2613 FAIRWAY DRIVE E
City FULTON
State MO
ZIP 65251
Phone 573 592-1964
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MADHUKER MISRA

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