01D0708682 CLIA NUMBER - FRESENIUS KIDNEY CARE SOUTH AVENUE FRESENIUS MEDICAL CARE SOUTH BIRMINGHAM DIALYSIS,

Laboratory Demographics

CLIA Number: 01D0708682

Facility Name: FRESENIUS KIDNEY CARE SOUTH AVENUE FRESENIUS MEDICAL CARE SOUTH BIRMINGHAM DIALYSIS,

Facility Address:
3201 3RD AVENUE SOUTH
BIRMINGHAM, AL
ZIP 35222
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Facility Phone Number: 205 502-5300

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1811662711

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0708682
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE SOUTH AVENUE FRESENIUS MEDICAL CARE SOUTH BIRMINGHAM DIALYSIS,
Street	3201 3RD AVENUE SOUTH
City	BIRMINGHAM
State	AL
ZIP	35222
Phone	205 502-5300
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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