01D0708708 CLIA NUMBER - WALKER COUNTY DIALYSIS

Laboratory Demographics

CLIA Number: 01D0708708

Facility Name: WALKER COUNTY DIALYSIS

Facility Address:
260 6TH AVE NW
JASPER, AL
ZIP 35504
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Facility Phone Number: 205 221-1506

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1295781268

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 01D0708708
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WALKER COUNTY DIALYSIS
Street 260 6TH AVE NW
City JASPER
State AL
ZIP 35504
Phone 205 221-1506
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