03D2112618 CLIA NUMBER - FRESENIUS MEDICAL CARE - GLENDALE TOWN CENTER

Laboratory Demographics

  • CLIA Code: 03D2112618
  • Facility Name: FRESENIUS MEDICAL CARE - GLENDALE TOWN CENTER
  • Facility Address: 4407 W PEORIA AVE
    GLENDALE, AZ
    ZIP 85302
  • Facility Phone: 623 934-9091
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHYAM COLATTUR
  • NPI Number: 1578947636
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2112618
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FRESENIUS MEDICAL CARE - GLENDALE TOWN CENTER
Street 4407 W PEORIA AVE
City GLENDALE
State AZ
ZIP 85302
Phone 623 934-9091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHYAM COLATTUR

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This page was last updated on: 6/4/2025