31D2144177 CLIA NUMBER - IRVINGTON DIALYSIS

Laboratory Demographics

  • CLIA Code: 31D2144177
  • Facility Name: IRVINGTON DIALYSIS
  • Facility Address: 468 CHANCELLOR AVE, SUITE WS-3
    IRVINGTON, NJ
    ZIP 07111
  • Facility Phone: 973 373-0294
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SEGUN V. SIMON
  • NPI Number: 1689176141
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 31D2144177
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name IRVINGTON DIALYSIS
Street 468 CHANCELLOR AVE, SUITE WS-3
City IRVINGTON
State NJ
ZIP 07111
Phone 973 373-0294
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SEGUN V. SIMON

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