32D2007811 CLIA NUMBER - DIALYSIS CLINIC INC - SANTO DOMINGO

Laboratory Demographics

  • CLIA Code: 32D2007811
  • Facility Name: DIALYSIS CLINIC INC - SANTO DOMINGO
  • Facility Address: 85 WEST HIGHWAY 22
    SANTO DOMINGO PUEBLO, NM
    ZIP 87052
  • Facility Phone: 505 465-2003
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JAMES I. GIBB
  • NPI Number: 1285962001
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D2007811
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS CLINIC INC - SANTO DOMINGO
Street 85 WEST HIGHWAY 22
City SANTO DOMINGO PUEBLO
State NM
ZIP 87052
Phone 505 465-2003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JAMES I. GIBB

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