36D2160785 CLIA NUMBER - MINERVA PARK DIALYSIS

Laboratory Demographics

  • CLIA Code: 36D2160785
  • Facility Name: MINERVA PARK DIALYSIS
  • Facility Address: 4401 CLEVELAND AVENUE, SUITE A
    COLUMBUS, OH
    ZIP 43224
  • Facility Phone: (614) 478-9604
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAMESH ANNADURAI
  • NPI Number: 1548725989
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2160785
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MINERVA PARK DIALYSIS
Street 4401 CLEVELAND AVENUE, SUITE A
City COLUMBUS
State OH
ZIP 43224
Phone 6144789604
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAMESH ANNADURAI

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This page was last updated on: 5/18/2026