33D2122825 CLIA NUMBER - JULIA AND ISRAEL WALDBAUM DIALYSIS

Laboratory Demographics

  • CLIA Code: 33D2122825
  • Facility Name: JULIA AND ISRAEL WALDBAUM DIALYSIS
  • Facility Address: 100 COMMUNITY DRIVE
    GREAT NECK, NY
    ZIP 11021
  • Facility Phone: 516 465-8250
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. RIMDA WANCHOO
  • NPI Number: 1043752769
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D2122825
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name JULIA AND ISRAEL WALDBAUM DIALYSIS
Street 100 COMMUNITY DRIVE
City GREAT NECK
State NY
ZIP 11021
Phone 516 465-8250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2016
Certificate Expiration Date 3/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. RIMDA WANCHOO

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This page was last updated on: 3/20/2025