33D2112825 CLIA NUMBER - IVY DIALYSIS

Laboratory Demographics

  • CLIA Code: 33D2112825
  • Facility Name: IVY DIALYSIS
  • Facility Address: 602 IVY STREET
    ELMIRA, NY
    ZIP 14905
  • Facility Phone: 607 737-4186
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. MOHAMED O. ATWAIBI
  • NPI Number: 1386028843
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2112825
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name IVY DIALYSIS
Street 602 IVY STREET
City ELMIRA
State NY
ZIP 14905
Phone 607 737-4186
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2016
Certificate Expiration Date 3/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. MOHAMED O. ATWAIBI

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