36D1092692 CLIA NUMBER - PREMIERE KIDNEY CENTER OF NEWARK

Laboratory Demographics

  • CLIA Code: 36D1092692
  • Facility Name: PREMIERE KIDNEY CENTER OF NEWARK
  • Facility Address: 65 SOUTH TERRACE AVENUE
    NEWARK, OH
    ZIP 43055
  • Facility Phone: 740 522-2955
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: STEPHANIE E. LADSON WOFFORD
  • NPI Number: 1831487313
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1092692
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PREMIERE KIDNEY CENTER OF NEWARK
Street 65 SOUTH TERRACE AVENUE
City NEWARK
State OH
ZIP 43055
Phone 740 522-2955
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director STEPHANIE E. LADSON WOFFORD

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