01D2027515 CLIA NUMBER - CROWN DIALYSIS

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Laboratory Demographics

CLIA Number: 01D2027515

Facility Name: CROWN DIALYSIS

Facility Address:
3007 27TH STREET NORTH
BIRMINGHAM, AL
ZIP 35207
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Facility Phone Number: 205 297-0143

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1659674190

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2027515
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CROWN DIALYSIS
Street	3007 27TH STREET NORTH
City	BIRMINGHAM
State	AL
ZIP	35207
Phone	205 297-0143
CertificateType	4
CertificateEffectiveDate	7/26/2023
CertificateExpirationDate	7/25/2025
FacilityType	Waiver

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