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SOUTHEASTERN RENAL DIALYSIS L.C.
NPI 1083670988
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Keokuk, IA

Active since April 21, 2006CLIA Certified · 2 labs
3/5
Overall Rating
1419 MORGAN ST, KEOKUK, IA 52632(319) 524-2105(319) 524-2188 Get Directions Write a Review

NPPES record last updated: March 16, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southeastern Renal Dialysis L.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN RENAL DIALYSIS L.C. (NPI 1083670988) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Keokuk, Iowa and active in the NPI registry since April 2006. The organization holds 2 active CLIA laboratory certificates and lists Mary Liechty, Administrator, as its authorized official.

NPPES Registry Identity

NPI1083670988
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameSOUTHEASTERN RENAL DIALYSIS L.C.
Location Address1419 MORGAN STKeokuk, IA 52632-4027
Mailing Address507 S White StMt Pleasant, IA 52641-2625
Phone(319) 524-2105
Fax(319) 524-2188
Organization SubpartYesParent: Southeastern Renal Dialysis
Authorized OfficialMary LiechtyAdministrator · (319) 385-6728
Enumeration DateApril 21, 2006
Last NPPES UpdateMarch 16, 2012
✔ NPI 1083670988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
1419 MORGAN ST, Keokuk, IA 52632
Open in Google Maps ↗

Other Identifiers 2

Medicaid0625178IA
Medicare OSCAR/certification162517IA

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D0993563

Southeastern Renal Dialysis · Keokuk, IA
Active · expires Mar 26, 2028
CLIA Number16D0993563
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateMarch 27, 2026
Certificate Expiration DateMarch 26, 2028
Laboratory DirectorKimberly M. Dewalt
Laboratory Phone(319) 524-2105
Laboratory LocationSoutheastern Renal Dialysis1419 Morgan Street, Keokuk, IA 52632
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D2341157

Southeastern Renal Dialysis · Mount Pleasant, IA
Active · expires Mar 26, 2028
CLIA Number16D2341157
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateMarch 27, 2026
Certificate Expiration DateMarch 26, 2028
Laboratory DirectorKimberly M. Dewalt
Laboratory Phone(319) 524-2105
Laboratory LocationSoutheastern Renal Dialysis507 S White, Mount Pleasant, IA 52641
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for Southeastern Renal Dialysis, L.C. - Lee County (CMS certification number 162517), from CMS Care Compare.

Southeastern Renal Dialysis, L.C. - Lee County

Dialysis facility · Keokuk, IA
3/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
CMS Certification Number162517
ESRD NetworkNetwork 12
Hemodialysis Stations10
Medicare-Certified SinceJanuary 6, 1999
Location1419 Morgan St.Keokuk, IA 52632 · Lee County
Phone(319) 524-2105
Services Offered
In-center hemodialysis

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeastern Renal Dialysis L.C.'s NPI number?

The NPI number for Southeastern Renal Dialysis L.C. is 1083670988. It was assigned to this organization in the NPPES registry on April 21, 2006.

Where is Southeastern Renal Dialysis L.C. located?

Southeastern Renal Dialysis L.C. is located at 1419 Morgan St, Keokuk, IA 52632. The listed phone number is (319) 524-2105.

What is Southeastern Renal Dialysis L.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Southeastern Renal Dialysis L.C. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

Is Southeastern Renal Dialysis L.C. a Medicare-certified dialysis facility?

Yes. Southeastern Renal Dialysis, L.C. - Lee County is a Medicare-certified dialysis facility, certified since January 6, 1999.

What quality rating does Southeastern Renal Dialysis L.C. have?

CMS rates Southeastern Renal Dialysis, L.C. - Lee County 3 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

When was this NPI record last updated?

The NPPES record for Southeastern Renal Dialysis L.C. was last updated on March 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.