01D0692344 CLIA NUMBER - DOTHAN DIALYSIS

Laboratory Demographics

CLIA Number: 01D0692344

Facility Name: DOTHAN DIALYSIS

Facility Address:
216 GRACELAND DRIVE
DOTHAN, AL
ZIP 36305
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Facility Phone Number: (334) 793-4077

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1215900501

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0692344
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	DOTHAN DIALYSIS
Street	216 GRACELAND DRIVE
City	DOTHAN
State	AL
ZIP	36305
Phone	(334) 793-4077

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This page was last updated on: 5/11/2023