45D2123422 CLIA NUMBER - SPACE CITY DIALYSIS PASADENA-DSI LLC DBA US RENAL CARE SPACE CITY DIALYSIS LLC

Laboratory Demographics

  • CLIA Code: 45D2123422
  • Facility Name: SPACE CITY DIALYSIS PASADENA-DSI LLC DBA US RENAL CARE SPACE CITY DIALYSIS LLC
  • Facility Address: 3402 BURKE ROAD
    PASADENA, TX
    ZIP 77504
  • Facility Phone: 713 425-0428
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MEHENDRA AGRAHARKAR
  • NPI Number: 1487105920
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2123422
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SPACE CITY DIALYSIS PASADENA-DSI LLC DBA US RENAL CARE SPACE CITY DIALYSIS LLC
Street 3402 BURKE ROAD
City PASADENA
State TX
ZIP 77504
Phone 713 425-0428
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MEHENDRA AGRAHARKAR

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