06D0994295 CLIA NUMBER - DIALYSIS CLINIC INC GRAND JUNCTION

Laboratory Demographics

CLIA Number: 06D0994295

Facility Name: DIALYSIS CLINIC INC GRAND JUNCTION

Facility Address:
2748 CROSSROADS BLVD
GRAND JUNCTION, CO
ZIP 81506
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Facility Phone Number: 970 255-0900

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1053344531

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D0994295
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CLINIC INC GRAND JUNCTION
Street	2748 CROSSROADS BLVD
City	GRAND JUNCTION
State	CO
ZIP	81506
Phone	970 255-0900
CertificateType	4
CertificateEffectiveDate	12/11/2023
CertificateExpirationDate	12/10/2025
FacilityType	Waiver

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