39D2062166 CLIA NUMBER - CITY LINE DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D2062166
  • Facility Name: CITY LINE DIALYSIS
  • Facility Address: 4508 CITY LINE AVE
    PHILADELPHIA, PA
    ZIP 19131
  • Facility Phone: 215 473-3071
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. RAKESH GULATI MD
  • NPI Number: 1396199881
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 39D2062166
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CITY LINE DIALYSIS
Street 4508 CITY LINE AVE
City PHILADELPHIA
State PA
ZIP 19131
Phone 215 473-3071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. RAKESH GULATI MD

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