01D0692344 CLIA NUMBER - DOTHAN DIALYSIS

Laboratory Demographics

  • Code: 01D0692344
  • Facility Name: DOTHAN DIALYSIS
  • Facility Address: 216 GRACELAND DRIVE
    DOTHAN, AL
    ZIP 36305
  • Facility Phone: 334 793-4077
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • NPI Number: 1215900501
  • Taxonomy: 261QE0700X - Clinic/Center
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CLIA Record

Field Name Field Value
CLIA Number 01D0692344
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DOTHAN DIALYSIS
Street 216 GRACELAND DRIVE
City DOTHAN
State AL
ZIP 36305
Phone 334 793-4077
Certificate Type 4
Certificate Effective Date 8/2/2022
Certificate Expiration Date 8/1/2024
Facility Type Waiver

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