OCONOMOWOC DIALYSIS CENTER
NPI 1871679480
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Oconomowoc, WI
- Organization
- Clinic/Center
- End-Stage Renal Disease (ESRD) Treatment
- CLIA Number: 52D0868858
- CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
- CLIA Exp. Date: 08-31-2026
About OCONOMOWOC DIALYSIS CENTER
This page provides the complete NPI Profile along with additional information for Oconomowoc Dialysis Center, a provider established in Oconomowoc, Wisconsin operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1871679480 assigned on October 2006. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated 16 years ago. The provider's is doing business as Oconomowoc Dialysis Center. The authorized official of this NPI record is Ms. Tina M Waldron (Billing Supervisor)
- NPI
- 1871679480 Verify this NPI
- Provider Legal Name
- PURITY DIALYSIS CENTERS, INC
- Other Organization Name
- OCONOMOWOC DIALYSIS CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1253 CORPORATE CENTER DR OCONOMOWOC, WI 53066
- Location Phone
- (262) 567-3199
- Location Fax
- (262) 567-3821
- Mailing Address
- 2301 SUN VALLEY DR STE 200 DELAFIELD, WI 53018
- Mailing Phone
- (262) 646-4162
- Mailing Fax
- (262) 646-2498
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-27-2006
- Last Update Date
- 05-13-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center End-Stage Renal Disease (ESRD) Treatment
- Taxonomy Code
- 261QE0700X
- Type
- Ambulatory Health Care Facilities
- License State
- WI
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 52D0868858 | OTHER (01) | WI | ODC CLIA # |
| 42052100 | MEDICAID (05) | WI | |
| 522517 | MEDICARE PIN (08) | WI |
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 this NPI number is:
- CLIA Number
- 52D0868858
- Facility Type
- End Stage Renal Disease Dialysis Facility
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- DR. LOGANATHAN ELANGOVAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Oconomowoc Dialysis Center 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.
Reviews for OCONOMOWOC DIALYSIS CENTER
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
OCONOMOWOC, WI 53066
OCONOMOWOC, WI 53066
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1871679480, enumerated as an "organization" on October 27, 2006.
The provider is located at 1253 CORPORATE CENTER DR OCONOMOWOC, WI 53066 and the phone number is (262) 567-3199.
Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
