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Clover Dialysis LLC

Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in San Jose, CA. Organization (NPI-2).

NPI number1457797474
StatusActive
Last updated in NPPESSep 9, 2026

Details

NPI
1457797474
Entity type
Organization (NPI-2)
Legal business name
Clover Dialysis LLC
Organization subpart
No
Enumeration date
May 16, 2013
Certification date
Sep 9, 2026
Last updated
Sep 9, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment550002503CAYes

Other names

  • Stevens Creek Dialysis (Doing Business As)

Practice location

275 Di Salvo Ave
San Jose, CA 95128-1628

Phone 408-297-0103 · Fax 408-297-2265

Mailing address

5200 Virginia Way
L & C Dept
Brentwood, TN 37027-7569

Authorized official

Samuel T Wey
Vp Licensure & Certification
6153416641

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