46D1059271 CLIA NUMBER - SRS-AMERICAN FORK, LLC DBA SRS-DIALYSIS OF AMERICAN FORK

Laboratory Demographics

  • CLIA Code: 46D1059271
  • Facility Name: SRS-AMERICAN FORK, LLC DBA SRS-DIALYSIS OF AMERICAN FORK
  • Facility Address: 1159 E 200 N, STE 150
    AMERICAN FORK, UT
    ZIP 84003
  • Facility Phone: 615 988-7881
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SIDDHARTHA KAKANI
  • NPI Number: 1720653942
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D1059271
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SRS-AMERICAN FORK, LLC DBA SRS-DIALYSIS OF AMERICAN FORK
Street 1159 E 200 N, STE 150
City AMERICAN FORK
State UT
ZIP 84003
Phone 615 988-7881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SIDDHARTHA KAKANI

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