31D2070529 CLIA NUMBER - RADBURN DIALYSIS

Laboratory Demographics

  • CLIA Code: 31D2070529
  • Facility Name: RADBURN DIALYSIS
  • Facility Address: 15-00 POLLITT DRIVE
    FAIR LAWN, NJ
    ZIP 07410
  • Facility Phone: 201 796-1385
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MIKHAIL KOTLOV
  • NPI Number: 1104258029
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2070529
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RADBURN DIALYSIS
Street 15-00 POLLITT DRIVE
City FAIR LAWN
State NJ
ZIP 07410
Phone 201 796-1385
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MIKHAIL KOTLOV

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