01D2154245 CLIA NUMBER - DIALYSIS CLINIC INC - SOUTH CULLMAN

Laboratory Demographics

CLIA Number: 01D2154245

Facility Name: DIALYSIS CLINIC INC - SOUTH CULLMAN

Facility Address:
208 BROADWAY DR SW
CULLMAN, AL
ZIP 35055
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Facility Phone Number: 256 737-8222

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1922514488

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2154245
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CLINIC INC - SOUTH CULLMAN
Street	208 BROADWAY DR SW
City	CULLMAN
State	AL
ZIP	35055
Phone	256 737-8222
CertificateType	4
CertificateEffectiveDate	9/10/2022
CertificateExpirationDate	9/9/2024
FacilityType	Waiver

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