49D1034833 CLIA NUMBER - FOREST PARK DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 49D1034833
  • Facility Name: FOREST PARK DIALYSIS CENTER
  • Facility Address: 1603 SANTA ROSA ROAD, SUITE 100
    RICHMOND, VA
    ZIP 23229
  • Facility Phone: 804 288-2751
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: TRUDY L. RICKMAN
  • NPI Number: 1912910159
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1034833
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FOREST PARK DIALYSIS CENTER
Street 1603 SANTA ROSA ROAD, SUITE 100
City RICHMOND
State VA
ZIP 23229
Phone 804 288-2751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director TRUDY L. RICKMAN

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