07D0994847 CLIA NUMBER - FRESENIUS MEDICAL CARE FORESTVILLE

Laboratory Demographics

CLIA Number: 07D0994847

Facility Name: FRESENIUS MEDICAL CARE FORESTVILLE

Facility Address:
135 MIDDLE STREET
BRISTOL, CT
ZIP 06010
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Facility Phone Number: 860 584-2155

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1043243413

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D0994847
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE FORESTVILLE
Street	135 MIDDLE STREET
City	BRISTOL
State	CT
ZIP	06010
Phone	860 584-2155
CertificateType	4
CertificateEffectiveDate	11/6/2022
CertificateExpirationDate	11/5/2024
FacilityType	Waiver

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