39D1007460 CLIA NUMBER - HANOVER DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D1007460
  • Facility Name: HANOVER DIALYSIS
  • Facility Address: 1155 CARLISLE ST, SUITE 610
    HANOVER, PA
    ZIP 17331
  • Facility Phone: 717 632-1681
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: AYOOLA AKINBAMOWO
  • NPI Number: 1174992838
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D1007460
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name HANOVER DIALYSIS
Street 1155 CARLISLE ST, SUITE 610
City HANOVER
State PA
ZIP 17331
Phone 717 632-1681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director AYOOLA AKINBAMOWO

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