03D1038510 CLIA NUMBER - DIALYSIS NEWCO, LLC DBA US RENAL CARE AVONDALE DIALYSIS

Laboratory Demographics

CLIA Number: 03D1038510

Facility Name: DIALYSIS NEWCO, LLC DBA US RENAL CARE AVONDALE DIALYSIS

Facility Address:
13055 W MCDOWELL RD, #101F
AVONDALE, AZ
ZIP 85323
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Facility Phone Number: 623 935-5460

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1144503699

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D1038510
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS NEWCO, LLC DBA US RENAL CARE AVONDALE DIALYSIS
Street	13055 W MCDOWELL RD, #101F
City	AVONDALE
State	AZ
ZIP	85323
Phone	623 935-5460
CertificateType	4
CertificateEffectiveDate	3/22/2023
CertificateExpirationDate	3/21/2025
FacilityType	Waiver

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