42D0906679 CLIA NUMBER - ALLENDALE COUNTY DIALYSIS

Laboratory Demographics

  • CLIA Code: 42D0906679
  • Facility Name: ALLENDALE COUNTY DIALYSIS
  • Facility Address: 1241 BOUNDARY ST W
    FAIRFAX, SC
    ZIP 29827
  • Facility Phone: 803 632-0000
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. SANJAY KUMAR
  • NPI Number: 1164529491
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0906679
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ALLENDALE COUNTY DIALYSIS
Street 1241 BOUNDARY ST W
City FAIRFAX
State SC
ZIP 29827
Phone 803 632-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. SANJAY KUMAR

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