46D0523120 CLIA NUMBER - TOOELE VALLEY DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 46D0523120
  • Facility Name: TOOELE VALLEY DIALYSIS CENTER
  • Facility Address: 2356 N 400 E SUITE B-102
    TOOELE, UT
    ZIP 84074
  • Facility Phone: 801 408-1430
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: GOPAL CHEMITI
  • NPI Number: 1134274947
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D0523120
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TOOELE VALLEY DIALYSIS CENTER
Street 2356 N 400 E SUITE B-102
City TOOELE
State UT
ZIP 84074
Phone 801 408-1430
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director GOPAL CHEMITI

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