31D2074385 CLIA NUMBER - EAST PATERSON DIALYSIS

Laboratory Demographics

  • CLIA Code: 31D2074385
  • Facility Name: EAST PATERSON DIALYSIS
  • Facility Address: 680 BROADWAY, SUITE 103
    PATERSON, NJ
    ZIP 07514
  • Facility Phone: 973 357-8079
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ANANTH N. PRAKASH
  • NPI Number: 1174954234
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2074385
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EAST PATERSON DIALYSIS
Street 680 BROADWAY, SUITE 103
City PATERSON
State NJ
ZIP 07514
Phone 973 357-8079
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ANANTH N. PRAKASH

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