01D1086739 CLIA NUMBER - RAI-EAST 11TH ST-ANNISTON

Laboratory Demographics

CLIA Number: 01D1086739

Facility Name: RAI-EAST 11TH ST-ANNISTON

Facility Address:
522 EAST 11TH STREET
ANNISTON, AL
ZIP 36207
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Facility Phone Number: 256 237-7566

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1659692713

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D1086739
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RAI-EAST 11TH ST-ANNISTON
Street	522 EAST 11TH STREET
City	ANNISTON
State	AL
ZIP	36207
Phone	256 237-7566
CertificateType	4
CertificateEffectiveDate	7/17/2022
CertificateExpirationDate	7/16/2024
FacilityType	Waiver

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