52D2013611 CLIA NUMBER - HUMBOLDT RIDGE DIALYSIS

Laboratory Demographics

  • CLIA Code: 52D2013611
  • Facility Name: HUMBOLDT RIDGE DIALYSIS
  • Facility Address: 2211 N HUMBOLDT BLVD
    MILWAUKEE, WI
    ZIP 53212
  • Facility Phone: 414 336-7200
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. KAMAL AMIN
  • NPI Number: 1043491194
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2013611
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name HUMBOLDT RIDGE DIALYSIS
Street 2211 N HUMBOLDT BLVD
City MILWAUKEE
State WI
ZIP 53212
Phone 414 336-7200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. KAMAL AMIN

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