39D2042348 CLIA NUMBER - STATE COLLEGE DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D2042348
  • Facility Name: STATE COLLEGE DIALYSIS
  • Facility Address: 500 SCIENCE PARK DR, SUITE 2
    STATE COLLEGE, PA
    ZIP 16803
  • Facility Phone: 814 237-3029
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. STACY L. ANDERSEN
  • NPI Number: 1548213580
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 39D2042348
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name STATE COLLEGE DIALYSIS
Street 500 SCIENCE PARK DR, SUITE 2
City STATE COLLEGE
State PA
ZIP 16803
Phone 814 237-3029
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. STACY L. ANDERSEN

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