01D2097691 CLIA NUMBER - FRESENIUS MEDICAL CARE ANNISTON HOME THERAPY

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Laboratory Demographics

CLIA Number: 01D2097691

Facility Name: FRESENIUS MEDICAL CARE ANNISTON HOME THERAPY

Facility Address:
2017 QUINTARD AVE SUITE A
ANNISTON, AL
ZIP 36201
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Facility Phone Number: 256 237-7496

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1679951974

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2097691
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE ANNISTON HOME THERAPY
Street	2017 QUINTARD AVE SUITE A
City	ANNISTON
State	AL
ZIP	36201
Phone	256 237-7496
CertificateType	4
CertificateEffectiveDate	6/23/2023
CertificateExpirationDate	6/22/2025
FacilityType	Waiver

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