36D1104015 CLIA NUMBER - BOARDMAN DIALYSIS CENTER LLC

Laboratory Demographics

  • CLIA Code: 36D1104015
  • Facility Name: BOARDMAN DIALYSIS CENTER LLC
  • Facility Address: 7153 TIFFANY BOULEVARD
    BOARDMAN, OH
    ZIP 44512
  • Facility Phone: 330 729-1355
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DANIEL P. BARTON
  • NPI Number: 1255491833
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 36D1104015
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BOARDMAN DIALYSIS CENTER LLC
Street 7153 TIFFANY BOULEVARD
City BOARDMAN
State OH
ZIP 44512
Phone 330 729-1355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DANIEL P. BARTON

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