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GOLDSBORO SOUTH DIALYSIS
NPI 1821058900
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Goldsboro, NC

Active since March 24, 2006CLIA 34D0924028 · Waiver
1704 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534(919) 739-6505(919) 739-6506 Get Directions Write a Review

NPPES record last updated: January 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 3, 2022, Jul 8, 2019 (2 updates tracked since 2019).

About Goldsboro South Dialysis NPPES

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

GOLDSBORO SOUTH DIALYSIS (NPI 1821058900) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Goldsboro, North Carolina and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through January 15, 2027 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1821058900
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameDVA RENAL HEALTHCARE INC
Location Address1704 WAYNE MEMORIAL DRGoldsboro, NC 27534-2240
Mailing Address5200 Virginia Way, L & C DeptBrentwood, TN 37027-7569 · (615) 320-4593 · Fax (800) 293-5872
Phone(919) 739-6505
Fax(919) 739-6506
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateMarch 24, 2006
Last NPPES UpdateJanuary 30, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 30, 2024
✔ NPI 1821058900 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
1704 WAYNE MEMORIAL DR, Goldsboro, NC 27534
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Other Names 1

Doing Business AsGoldsboro South Dialysis

Other Identifiers 1

Medicaid3412587NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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 34D0924028

Goldsboro South Dialysis · Goldsboro, NC
Active · expires Jan 15, 2027
CLIA Number34D0924028
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateJanuary 16, 2025
Certificate Expiration DateJanuary 15, 2027
Laboratory DirectorAjay Shreenath
Laboratory Phone(919) 739-6505
Laboratory LocationGoldsboro South Dialysis1704 Wayne Memorial Dr, Goldsboro, NC 27530
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 DVA Renal Healthcare Inc's NPI number?

The NPI number for DVA Renal Healthcare Inc is 1821058900. It was assigned to this organization in the NPPES registry on March 24, 2006. The provider is doing business as Goldsboro South Dialysis.

Where is DVA Renal Healthcare Inc located?

DVA Renal Healthcare Inc is located at 1704 Wayne Memorial Dr, Goldsboro, NC 27534. The listed phone number is (919) 739-6505.

What is DVA Renal Healthcare 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 DVA Renal Healthcare Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0924028) is associated with this NPI, valid through January 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does DVA Renal Healthcare Inc accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 7 other insurers list DVA Renal Healthcare 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 DVA Renal Healthcare Inc was last updated on January 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.