36D0995938 CLIA NUMBER - MID-AMERICA DIALYSIS

Laboratory Demographics

CLIA Number: 36D0995938

Facility Name: MID-AMERICA DIALYSIS

Facility Address:
2355 SOUTH HAMILTON ROAD
COLUMBUS, OH
ZIP 43232
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Facility Phone Number: 614 367-1679

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1194834903

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D0995938
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	MID-AMERICA DIALYSIS
Street	2355 SOUTH HAMILTON ROAD
City	COLUMBUS
State	OH
ZIP	43232
Phone	614 367-1679
CertificateType	4
CertificateEffectiveDate	2/5/2024
CertificateExpirationDate	2/4/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024