03D0929928 CLIA NUMBER - SUN DESERT DIALYSIS, LLC DBA DESERT DIALYSIS

Laboratory Demographics

CLIA Number: 03D0929928

Facility Name: SUN DESERT DIALYSIS, LLC DBA DESERT DIALYSIS

Facility Address:
13000 N 103RD AVENUE, STE 66
SUN CITY, AZ
ZIP 85351
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Facility Phone Number: 615 341-6814

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1396013108

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D0929928
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SUN DESERT DIALYSIS, LLC DBA DESERT DIALYSIS
Street	13000 N 103RD AVENUE, STE 66
City	SUN CITY
State	AZ
ZIP	85351
Phone	615 341-6814
CertificateType	4
CertificateEffectiveDate	6/25/2023
CertificateExpirationDate	6/24/2025
FacilityType	Waiver

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