33D2218455 CLIA NUMBER - SMITHTOWN DIALYSIS

Laboratory Demographics

  • CLIA Code: 33D2218455
  • Facility Name: SMITHTOWN DIALYSIS
  • Facility Address: 113 TERRY RD
    SMITHTOWN, NY
    ZIP 11787
  • Facility Phone: 631 360-7801
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. KHURRAM MEHTABDIN
  • NPI Number: 1346377553
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 33D2218455
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SMITHTOWN DIALYSIS
Street 113 TERRY RD
City SMITHTOWN
State NY
ZIP 11787
Phone 631 360-7801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2021
Certificate Expiration Date 3/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. KHURRAM MEHTABDIN

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