36D1081485 CLIA NUMBER - LOGAN DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D1081485
  • Facility Name: LOGAN DIALYSIS
  • Facility Address: 12880 GREY STREET
    LOGAN, OH
    ZIP 43138
  • Facility Phone: 740 380-6049
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: WILLIAM WILMER
  • NPI Number: 1407030802
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1081485
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LOGAN DIALYSIS
Street 12880 GREY STREET
City LOGAN
State OH
ZIP 43138
Phone 740 380-6049
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director WILLIAM WILMER

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