36D1095395 CLIA NUMBER - CHERRY VALLEY DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D1095395
  • Facility Name: CHERRY VALLEY DIALYSIS
  • Facility Address: 1627 WEST MAIN STREET
    NEWARK, OH
    ZIP 43055
  • Facility Phone: 740 522-1699
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: HINTSA A. TEWOLDEMEDHIN MD
  • NPI Number: 1801117429
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1095395
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CHERRY VALLEY DIALYSIS
Street 1627 WEST MAIN STREET
City NEWARK
State OH
ZIP 43055
Phone 740 522-1699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director HINTSA A. TEWOLDEMEDHIN MD

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