07D1060901 CLIA NUMBER - VERNON DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 07D1060901

Facility Name: VERNON DIALYSIS CENTER

Facility Address:
460 HARTFORD TURNPIKE
VERNON, CT
ZIP 06066
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Facility Phone Number: 860 896-4896

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1942244363

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D1060901
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	VERNON DIALYSIS CENTER
Street	460 HARTFORD TURNPIKE
City	VERNON
State	CT
ZIP	06066
Phone	860 896-4896
CertificateType	4
CertificateEffectiveDate	11/3/2022
CertificateExpirationDate	11/2/2024
FacilityType	Waiver

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