03D2274948 CLIA NUMBER - CDI HEALTH PEORIA DIALYSIS LLC

Laboratory Demographics

CLIA Number: 03D2274948

Facility Name: CDI HEALTH PEORIA DIALYSIS LLC

Facility Address:
13216 N N PLAZA DEL RIO BLVD STE 701
PEORIA, AZ
ZIP 85381
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Facility Phone Number: 512 599-8022

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1992346316

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2274948
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CDI HEALTH PEORIA DIALYSIS LLC
Street	13216 N N PLAZA DEL RIO BLVD STE 701
City	PEORIA
State	AZ
ZIP	85381
Phone	512 599-8022
CertificateType	4
CertificateEffectiveDate	1/12/2023
CertificateExpirationDate	1/11/2025
FacilityType	Waiver

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