03D0976878 CLIA NUMBER - FMC DIALYSIS SERVICES DEER VALLEY

Laboratory Demographics

  • CLIA Code: 03D0976878
  • Facility Name: FMC DIALYSIS SERVICES DEER VALLEY
  • Facility Address: 21241 N 23RD AVE SUITE 11
    PHOENIX, AZ
    ZIP 85027
  • Facility Phone: 623 869-6089
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SUNGCHUN LEE
  • NPI Number: 1891817300
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 03D0976878
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FMC DIALYSIS SERVICES DEER VALLEY
Street 21241 N 23RD AVE SUITE 11
City PHOENIX
State AZ
ZIP 85027
Phone 623 869-6089
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SUNGCHUN LEE

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This page was last updated on: 9/29/2025