45D2037203 CLIA NUMBER - SAN ANGELO DIALYSIS

Laboratory Demographics

  • CLIA Code: 45D2037203
  • Facility Name: SAN ANGELO DIALYSIS
  • Facility Address: 3518 KNICKERBOCKER RD
    SAN ANGELO, TX
    ZIP 76904
  • Facility Phone: 325 949-6189
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JOHN STEVENSEN
  • NPI Number: 1659394617
  • Taxonomy: 273Y00000X - Rehabilitation Unit

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CLIA Record

Field Name Field Value
CLIA Number 45D2037203
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SAN ANGELO DIALYSIS
Street 3518 KNICKERBOCKER RD
City SAN ANGELO
State TX
ZIP 76904
Phone 325 949-6189
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JOHN STEVENSEN

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