01D0908265 CLIA NUMBER - DIALYSIS CLINIC INC - CULLMAN

Laboratory Demographics

CLIA Number: 01D0908265

Facility Name: DIALYSIS CLINIC INC - CULLMAN

Facility Address:
1734 EVA ROAD NE
CULLMAN, AL
ZIP 35055
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Facility Phone Number: 256 734-3055

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1063445443

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0908265
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CLINIC INC - CULLMAN
Street	1734 EVA ROAD NE
City	CULLMAN
State	AL
ZIP	35055
Phone	256 734-3055
CertificateType	4
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Waiver

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