39D1076845 CLIA NUMBER - WARREN DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D1076845
  • Facility Name: WARREN DIALYSIS
  • Facility Address: 2 CRESCENT PARK W
    WARREN, PA
    ZIP 16365
  • Facility Phone: 814 728-5570
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: EDWARD C. CLARK MD
  • NPI Number: 1245419126
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D1076845
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WARREN DIALYSIS
Street 2 CRESCENT PARK W
City WARREN
State PA
ZIP 16365
Phone 814 728-5570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director EDWARD C. CLARK MD

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