01D0938643 CLIA NUMBER - RCG WALKER

Laboratory Demographics

CLIA Number: 01D0938643

Facility Name: RCG WALKER

Facility Address:
3510 3RD STREET NE
JASPER, AL
ZIP 35504
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Facility Phone Number: 205 221-8775

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1376655118

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0938643
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RCG WALKER
Street	3510 3RD STREET NE
City	JASPER
State	AL
ZIP	35504
Phone	205 221-8775
CertificateType	4
CertificateEffectiveDate	1/12/2024
CertificateExpirationDate	1/11/2026
FacilityType	Waiver

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