31D1004777 CLIA NUMBER - MIDDLETOWN DIALYSIS CENTER SHINING STAR DIALYSIS INC

Laboratory Demographics

  • CLIA Code: 31D1004777
  • Facility Name: MIDDLETOWN DIALYSIS CENTER SHINING STAR DIALYSIS INC
  • Facility Address: 500 ROUTE 35 SOUTH UNION SQUARE PLAZA
    RED BANK, NJ
    ZIP 07701
  • Facility Phone: 732 576-9900
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAYMOND FLISS
  • NPI Number: 1427082361
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D1004777
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MIDDLETOWN DIALYSIS CENTER SHINING STAR DIALYSIS INC
Street 500 ROUTE 35 SOUTH UNION SQUARE PLAZA
City RED BANK
State NJ
ZIP 07701
Phone 732 576-9900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAYMOND FLISS

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