36D0996727 CLIA NUMBER - MIDWEST FAIRBORN DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D0996727
  • Facility Name: MIDWEST FAIRBORN DIALYSIS
  • Facility Address: 1266 NORTH BROAD STREET
    FAIRBORN, OH
    ZIP 45324
  • Facility Phone: 937 328-8933
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: PIUS KURIAN
  • NPI Number: 1306162581
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D0996727
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MIDWEST FAIRBORN DIALYSIS
Street 1266 NORTH BROAD STREET
City FAIRBORN
State OH
ZIP 45324
Phone 937 328-8933
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director PIUS KURIAN

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