36D2045081 CLIA NUMBER - BUCKEYE DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D2045081
  • Facility Name: BUCKEYE DIALYSIS
  • Facility Address: 3050 S DIXIE DR
    KETTERING, OH
    ZIP 45409
  • Facility Phone: 937 643-2337
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SIVA AMBALAVANAN
  • NPI Number: 1912269929
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2045081
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BUCKEYE DIALYSIS
Street 3050 S DIXIE DR
City KETTERING
State OH
ZIP 45409
Phone 937 643-2337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SIVA AMBALAVANAN

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