37D2090952 CLIA NUMBER - MOORE DIALYSIS

Laboratory Demographics

  • CLIA Code: 37D2090952
  • Facility Name: MOORE DIALYSIS
  • Facility Address: 620 S SANTA FE AVE, STE C
    MOORE, OK
    ZIP 73160
  • Facility Phone: 000 405-7992
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DUSTIN S. TEDESCO
  • NPI Number: 1821496217
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2090952
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MOORE DIALYSIS
Street 620 S SANTA FE AVE, STE C
City MOORE
State OK
ZIP 73160
Phone 000 405-7992
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DUSTIN S. TEDESCO

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