07D1012969 CLIA NUMBER - BLOOMFIELD DIALYSIS

Laboratory Demographics

CLIA Number: 07D1012969

Facility Name: BLOOMFIELD DIALYSIS

Facility Address:
29 GRIFFIN ROAD SOUTH
BLOOMFIELD, CT
ZIP 06002
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Facility Phone Number: 860 243-5389

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1477528271

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D1012969
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BLOOMFIELD DIALYSIS
Street	29 GRIFFIN ROAD SOUTH
City	BLOOMFIELD
State	CT
ZIP	06002
Phone	860 243-5389
CertificateType	4
CertificateEffectiveDate	5/27/2023
CertificateExpirationDate	5/26/2025
FacilityType	Waiver

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