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OLD FORGE DIALYSIS
NPI 1760444533
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Old Forge, PA

Active since April 05, 2006CLIA 39D2165614 · Waiver
1/5
Overall Rating
325 S MAIN ST, OLD FORGE, PA 18518(570) 457-3174(570) 457-3313 Get Directions Write a Review

NPPES record last updated: May 1, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 1, 2024, Oct 26, 2023, Oct 13, 2023 and 2 more (5 updates tracked since 2019).

About Old Forge Dialysis NPPES

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

OLD FORGE DIALYSIS (NPI 1760444533) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Old Forge, Pennsylvania and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through May 1, 2027 and lists Samuel Wey, Vp, Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1760444533
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameRENAL LIFE LINK INC
Location Address325 S MAIN STOld Forge, PA 18518-1677
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Phone(570) 457-3174
Fax(570) 457-3313
Organization SubpartNo
Authorized OfficialSamuel WeyVp, Licensure & Certification · (615) 341-6641
Enumeration DateApril 5, 2006
Last NPPES UpdateMay 1, 20245 updates tracked since enumeration
NPPES CertifiedMay 1, 2024
✔ NPI 1760444533 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
325 S MAIN ST, Old Forge, PA 18518
Open in Google Maps ↗

Other Names 1

Doing Business AsOld Forge Dialysis

Other Identifiers 1

Medicaid1014890420002PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.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 39D2165614

Old Forge Dialysis · Old Forge, PA
Active · expires May 1, 2027
CLIA Number39D2165614
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateMay 2, 2025
Certificate Expiration DateMay 1, 2027
Laboratory DirectorDr. Asad Shafiq
Laboratory Phone(570) 457-3174
Laboratory LocationOld Forge Dialysis325 S Main St, Old Forge, PA 18518
CLIA data matches this NPI record on: Address 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 DaVita Old Forge Dialysis (CMS certification number 392726), from CMS Care Compare.

DaVita Old Forge Dialysis

Dialysis facility · Old Forge, PA
1/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number392726
ESRD NetworkNetwork 4
Hemodialysis Stations12
Medicare-Certified SinceMay 1, 2005
Location325 South Main StreetOld Forge, PA 18518 · Lackawanna County
Phone(570) 457-3174
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 Renal Life Link Inc's NPI number?

The NPI number for Renal Life Link Inc is 1760444533. It was assigned to this organization in the NPPES registry on April 5, 2006. The provider is doing business as Old Forge Dialysis.

Where is Renal Life Link Inc located?

Renal Life Link Inc is located at 325 S Main St, Old Forge, PA 18518. The listed phone number is (570) 457-3174.

What is Renal Life Link Inc'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 Renal Life Link Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2165614) is associated with this NPI, valid through May 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Renal Life Link Inc a Medicare-certified dialysis facility?

Yes. DaVita Old Forge Dialysis is a Medicare-certified dialysis facility, certified since May 1, 2005.

What quality rating does Renal Life Link Inc have?

CMS rates DaVita Old Forge Dialysis 1 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Renal Life Link Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Oscar Health Insurance and Oscar Health Maintenance Organization of Florida and 5 other insurers list Renal Life Link Inc 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 Renal Life Link Inc was last updated on May 1, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.