50D1070338 CLIA NUMBER - VANCOUVER DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 50D1070338
  • Facility Name: VANCOUVER DIALYSIS CENTER
  • Facility Address: 9120 NE VANCOUVER MALL DR
    VANCOUVER, WA
    ZIP 98662
  • Facility Phone: 360 891-5777
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SUDHA PIDIKITI
  • NPI Number: 1467470369
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D1070338
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name VANCOUVER DIALYSIS CENTER
Street 9120 NE VANCOUVER MALL DR
City VANCOUVER
State WA
ZIP 98662
Phone 360 891-5777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2007
Certificate Expiration Date 4/4/2028
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SUDHA PIDIKITI

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