45D1020688 CLIA NUMBER - KILGORE DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 45D1020688
  • Facility Name: KILGORE DIALYSIS CENTER
  • Facility Address: 2403 STATE HWY 42 NORTH
    KILGORE, TX
    ZIP 75662
  • Facility Phone: 903 988-8200
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: GLENN A. MCDONALD
  • NPI Number: 1992021661
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D1020688
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name KILGORE DIALYSIS CENTER
Street 2403 STATE HWY 42 NORTH
City KILGORE
State TX
ZIP 75662
Phone 903 988-8200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2023
Certificate Expiration Date 12/28/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director GLENN A. MCDONALD

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