32D0876783 CLIA NUMBER - DIALYSIS CLINIC INC GRANTS

Laboratory Demographics

  • CLIA Code: 32D0876783
  • Facility Name: DIALYSIS CLINIC INC GRANTS
  • Facility Address: 1213 BONITA ST ATTN BECKY
    GRANTS, NM
    ZIP 87020
  • Facility Phone: 505 285-5200
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: PHILIP G. ZAGER
  • NPI Number: 1447283825
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D0876783
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS CLINIC INC GRANTS
Street 1213 BONITA ST ATTN BECKY
City GRANTS
State NM
ZIP 87020
Phone 505 285-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director PHILIP G. ZAGER

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