31D2162456 CLIA NUMBER - SOUTH DEAN DIALYSIS

Laboratory Demographics

  • CLIA Code: 31D2162456
  • Facility Name: SOUTH DEAN DIALYSIS
  • Facility Address: 100 W FOREST AVENUE, SUITE G
    ENGLEWOOD, NJ
    ZIP 07631
  • Facility Phone: 201 816-9710
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: STANLEY S. KIM
  • NPI Number: 1942567755
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 31D2162456
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTH DEAN DIALYSIS
Street 100 W FOREST AVENUE, SUITE G
City ENGLEWOOD
State NJ
ZIP 07631
Phone 201 816-9710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director STANLEY S. KIM

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