36D2055937 CLIA NUMBER - KENTON DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D2055937
  • Facility Name: KENTON DIALYSIS
  • Facility Address: 1207 E COLUMBUS ST
    KENTON, OH
    ZIP 43326
  • Facility Phone: 419 673-8978
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ANIL MUDDADA
  • NPI Number: 1730427493
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2055937
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name KENTON DIALYSIS
Street 1207 E COLUMBUS ST
City KENTON
State OH
ZIP 43326
Phone 419 673-8978
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ANIL MUDDADA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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