I have a clinic manager that said they would like to start having a dialysate flow 1.5x to go to 2.0 ... My question is my machine will only go to 1.5x so what do i have to do to get it to 2.0?

Upgrade to a different machine... or tell her no can do sorry!

Most likely there is a setting in Service Mode whoch can be changed to allow 2.0 as well as 1.5 autoflow.

What kind of machine do you have? With the 2008K 2X autoflow is one of your choices under the flow menu. To get 1.5X you have to get an upgrade chip.