USRC DIALYSIS AT HOME WEST LLC NPI 1003422171

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) in San Antonio, TX

NPI 1003422171 Organization Clinic/Center End-Stage Renal Disease (ESRD) Treatment CLIA Number 45D2222968 CLIA Certificate of Waiver

About USRC DIALYSIS AT HOME WEST LLC

Usrc Dialysis At Home West Llc is a provider established in San Antonio, Texas specializing in clinic/center (end-stage renal disease (esrd) treatment) . The NPI number of Usrc Dialysis At Home West Llc is 1003422171 and was assigned on September 2020. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Thomas L Weinberg (Chairman)

The CLIA number of Usrc Dialysis At Home West Llc is 45D2222968 registered as a "end stage renal disease dialysis" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Usrc Dialysis At Home West Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003422171

Provider NameUSRC DIALYSIS AT HOME WEST LLC
Provider Location Address12011 STATE HIGHWAY 151 STE 222 SAN ANTONIO, TX 78251
Provider Mailing AddressPO BOX 251549 PLANO, TX 75025
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date09-23-2020
Last Update Date09-23-2020


Primary Taxonomy

Taxonomy Code261QE0700X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationEnd-Stage Renal Disease (ESRD) Treatment

Business Address

USRC DIALYSIS AT HOME WEST LLC
12011 STATE HIGHWAY 151 STE 222
SAN ANTONIO, TX
ZIP 78251
Phone: (726) 800-7090
Fax: (726) 800-7075

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Mailing Address

USRC DIALYSIS AT HOME WEST LLC
PO BOX 251549
PLANO, TX
ZIP 75025
Phone: (214) 736-2700



Authorized Official

Authorized Official Name THOMAS L WEINBERG
Authorized Official TitleCHAIRMAN
Authorized Official Phone(214) 736-2730

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003422171 is:

CLIA Number45D2222968
Facility TypeEND STAGE RENAL DISEASE DIALYSIS
Certificate TypeCertificate of Waiver

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.