45D2109404 CLIA NUMBER - GARLAND SHILOH DIALYSIS

Laboratory Demographics

  • CLIA Code: 45D2109404
  • Facility Name: GARLAND SHILOH DIALYSIS
  • Facility Address: 800 N SHILOH ROAD
    GARLAND, TX
    ZIP 75042
  • Facility Phone: 972 276-7961
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JOHN HARTONO
  • NPI Number: 1982080222
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2109404
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GARLAND SHILOH DIALYSIS
Street 800 N SHILOH ROAD
City GARLAND
State TX
ZIP 75042
Phone 972 276-7961
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JOHN HARTONO

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