Organization · Type 2 NPI

Tyler Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Mount Laurel, NJ

NPI number 1215287941 Active

Practice location

3716 Church Rd
Mount Laurel, NJ 08054-1104

Call (856) 222-0386 Map

Fax (856) 235-0592

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	24255 (NJ)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1215287941
Entity type: Organization (Type 2)
Issued: Sep 10, 2012
Last updated: Mar 6, 2026
Status: Active

Other names

<unavail>
Lourdes Innova Dialysis · doing business as
Lourdes Innova Dialysis · doing business as

Authorized official

Samuel Wey
VP, Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1215287941

Tyler Dialysis LLC's National Provider Identifier is 1215287941, issued on Sep 10, 2012. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Mount Laurel, NJ. The record was last updated on Mar 6, 2026.