36D1014443 CLIA NUMBER - KIDNEY SPECIALIST INC

Laboratory Demographics

  • CLIA Code: 36D1014443
  • Facility Name: KIDNEY SPECIALIST INC
  • Facility Address: 595 COPELAND MILL RD SUITE 2D
    WESTERVILLE, OH
    ZIP 43081
  • Facility Phone: 614 823-8500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WILLIAM A. WILMER MD
  • NPI Number: 1124038963
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D1014443
LAB Type Physician Office
Facility Name KIDNEY SPECIALIST INC
Street 595 COPELAND MILL RD SUITE 2D
City WESTERVILLE
State OH
ZIP 43081
Phone 614 823-8500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/7/2025
Certificate Expiration Date 7/6/2027
Facility Type Physician Office
Lab Director WILLIAM A. WILMER MD

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