52D2247283 CLIA NUMBER - RICE LAKE DIALYSIS

Laboratory Demographics

  • CLIA Code: 52D2247283
  • Facility Name: RICE LAKE DIALYSIS
  • Facility Address: 1700 W STOUT ST
    RICE LAKE, WI
    ZIP 54868
  • Facility Phone: 715 236-6159
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. NATHANIEL S. JALIL
  • NPI Number: 1063172112
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2247283
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RICE LAKE DIALYSIS
Street 1700 W STOUT ST
City RICE LAKE
State WI
ZIP 54868
Phone 715 236-6159
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. NATHANIEL S. JALIL

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