IRC-SUTTER HEALTH JACKSON LLC
NPI 1124893615
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Jackson, CA
About Irc-sutter Health Jackson Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IRC-SUTTER HEALTH JACKSON LLC (NPI 1124893615), doing business as Innovative Renal Care Jackson Dialysis Center, is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Jackson, California and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through April 9, 2028 and lists Sara Anne Brady, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
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 05D2302474
Irc-Sutter Health Jackson, LLC · Jackson, CAFrequently 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 Irc-Sutter Health Jackson LLC's NPI number?
The NPI number for Irc-Sutter Health Jackson LLC is 1124893615. It was assigned to this organization in the NPPES registry on November 15, 2023. The provider is doing business as Innovative Renal Care Jackson Dialysis Center.
Where is Irc-Sutter Health Jackson LLC located?
Irc-Sutter Health Jackson LLC is located at 12030 Industry Blvd, Jackson, CA 95642. The listed phone number is (209) 273-3060.
What is Irc-Sutter Health Jackson LLC'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 Irc-Sutter Health Jackson LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2302474) is associated with this NPI, valid through April 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Irc-Sutter Health Jackson LLC accept?
Health plans from UnitedHealthcare list Irc-Sutter Health Jackson LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Irc-Sutter Health Jackson LLC was last updated on June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Irc-Sutter Health Jackson Llc · NPI 1124893615
End-Stage Renal Disease (ESRD) Treatment organization in Jackson, California. Organization record, active in the CMS NPPES registry since November 15, 2023.
## Identity
- **NPI:** 1124893615 (Entity type: Organization)
- **Enumerated:** November 15, 2023
- **Primary specialty:** Clinic/Center - End-Stage Renal Disease (ESRD) Treatment · taxonomy 261QE0700X
- **Also known as:** INNOVATIVE RENAL CARE JACKSON DIALYSIS CENTER (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Sara Brady, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 12030 INDUSTRY BLVD, Jackson, CA 95642-9371
- **Phone:** (209) 273-3060 · **Fax:** (209) 273-3374
## Record status
- **NPPES last updated:** June 8, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124893615) · Data from the CMS NPPES public registry.