44D2156601 CLIA NUMBER - ISD RENAL INC DBA LEWIS CREEK DIALYSIS

Laboratory Demographics

  • CLIA Code: 44D2156601
  • Facility Name: ISD RENAL INC DBA LEWIS CREEK DIALYSIS
  • Facility Address: 620 MALL BLVD SUITE E
    DYERSBURG, TN
    ZIP 38024
  • Facility Phone: 731 287-9448
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. VICTOR C. NWAZUE
  • NPI Number: 1619459682
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2156601
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ISD RENAL INC DBA LEWIS CREEK DIALYSIS
Street 620 MALL BLVD SUITE E
City DYERSBURG
State TN
ZIP 38024
Phone 731 287-9448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. VICTOR C. NWAZUE

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