04D1037080 CLIA NUMBER - NORTH HILLS DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 04D1037080

Facility Name: NORTH HILLS DIALYSIS CENTER

Facility Address:
107 EAST MONTE PAINTER DRIVE
FAYETTEVILLE, AR
ZIP 72703
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Facility Phone Number: 479 463-7000

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1942286315

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D1037080
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NORTH HILLS DIALYSIS CENTER
Street	107 EAST MONTE PAINTER DRIVE
City	FAYETTEVILLE
State	AR
ZIP	72703
Phone	479 463-7000
CertificateType	4
CertificateEffectiveDate	2/15/2023
CertificateExpirationDate	2/14/2025
FacilityType	Waiver

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