50D2072615 CLIA NUMBER - PNRS CLARK COUNTY DIALYSIS CLINIC

Laboratory Demographics

  • CLIA Code: 50D2072615
  • Facility Name: PNRS CLARK COUNTY DIALYSIS CLINIC
  • Facility Address: 3921 SW 13TH AVE
    BATTLE GROUND, WA
    ZIP 98604
  • Facility Phone: 360 687-8527
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SUDHA PIDIKITI
  • NPI Number: 1265855696
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D2072615
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PNRS CLARK COUNTY DIALYSIS CLINIC
Street 3921 SW 13TH AVE
City BATTLE GROUND
State WA
ZIP 98604
Phone 360 687-8527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2014
Certificate Expiration Date 4/4/2028
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SUDHA PIDIKITI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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