32D0969559 CLIA NUMBER - DIALYSIS CLINIC INC

Laboratory Demographics

  • CLIA Code: 32D0969559
  • Facility Name: DIALYSIS CLINIC INC
  • Facility Address: 80 A VETERANS BLVD
    PUEBLO OF ACOMA, NM
    ZIP 87034
  • Facility Phone: 505 552-7292
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHAN SHAN CHEN
  • NPI Number: 1205869690
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D0969559
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS CLINIC INC
Street 80 A VETERANS BLVD
City PUEBLO OF ACOMA
State NM
ZIP 87034
Phone 505 552-7292
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHAN SHAN CHEN

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