01D0641600 CLIA NUMBER - FLORENCE DIALYSIS

Laboratory Demographics

CLIA Number: 01D0641600

Facility Name: FLORENCE DIALYSIS

Facility Address:
422 E DR HICKS BLVD
FLORENCE, AL
ZIP 35630
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Facility Phone Number: 256 764-5050

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1457324220

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 01D0641600
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FLORENCE DIALYSIS
Street 422 E DR HICKS BLVD
City FLORENCE
State AL
ZIP 35630
Phone 256 764-5050
CertificateType 4
CertificateEffectiveDate 9/3/2023
CertificateExpirationDate 9/2/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024