44D0992984 CLIA NUMBER - DIALYSIS ASSOCIATES OF PORTLAND

Laboratory Demographics

  • CLIA Code: 44D0992984
  • Facility Name: DIALYSIS ASSOCIATES OF PORTLAND
  • Facility Address: 923 SOUTH BROADWAY
    PORTLAND, TN
    ZIP 37148
  • Facility Phone: 615 323-7065
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DAVID CHOMA
  • NPI Number: 1629180443
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D0992984
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS ASSOCIATES OF PORTLAND
Street 923 SOUTH BROADWAY
City PORTLAND
State TN
ZIP 37148
Phone 615 323-7065
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DAVID CHOMA

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