39D2159476 CLIA NUMBER - DUKE STREET DIALYSIS

Laboratory Demographics

  • CLIA Code: 39D2159476
  • Facility Name: DUKE STREET DIALYSIS
  • Facility Address: 901 E MAIN ST, SUITE 12
    PALMYRA, PA
    ZIP 17078
  • Facility Phone: 717 832-1390
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. RONALD P. MILLER
  • NPI Number: 1629546577
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 39D2159476
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DUKE STREET DIALYSIS
Street 901 E MAIN ST, SUITE 12
City PALMYRA
State PA
ZIP 17078
Phone 717 832-1390
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. RONALD P. MILLER

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This page was last updated on: 6/4/2025