45D2222968 CLIA NUMBER - USRC DIALYSIS AT HOME WEST LLC

Laboratory Demographics

  • CLIA Code: 45D2222968
  • Facility Name: USRC DIALYSIS AT HOME WEST LLC
  • Facility Address: 12011 STATE HWY 151, SUITE 222
    SAN ANTONIO, TX
    ZIP 78251
  • Facility Phone: 726 800-7090
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: VARSHASB BROUMAND
  • NPI Number: 1003422171
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2222968
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name USRC DIALYSIS AT HOME WEST LLC
Street 12011 STATE HWY 151, SUITE 222
City SAN ANTONIO
State TX
ZIP 78251
Phone 726 800-7090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2023
Certificate Expiration Date 5/2/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director VARSHASB BROUMAND

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This page was last updated on: 3/20/2025