07D2091766 CLIA NUMBER - HOUSATONIC DIALYSIS

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Laboratory Demographics

CLIA Number: 07D2091766

Facility Name: HOUSATONIC DIALYSIS

Facility Address:
164 MOUNT PLEASANT RD
NEWTOWN, CT
ZIP 06470
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Facility Phone Number: 860 749-0476

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1417345828

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D2091766
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HOUSATONIC DIALYSIS
Street	164 MOUNT PLEASANT RD
City	NEWTOWN
State	CT
ZIP	06470
Phone	860 749-0476
CertificateType	4
CertificateEffectiveDate	2/19/2023
CertificateExpirationDate	2/18/2025
FacilityType	Waiver

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