36D0917850 CLIA NUMBER - SHAKER SQUARE DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D0917850
  • Facility Name: SHAKER SQUARE DIALYSIS
  • Facility Address: 12800 SHAKER BLVD, STE 1
    CLEVELAND, OH
    ZIP 44120
  • Facility Phone: 216 491-4867
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: VASUKI VENKAT
  • NPI Number: 1124171624
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 36D0917850
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SHAKER SQUARE DIALYSIS
Street 12800 SHAKER BLVD, STE 1
City CLEVELAND
State OH
ZIP 44120
Phone 216 491-4867
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director VASUKI VENKAT

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