07D2111956 CLIA NUMBER - HERALD SQUARE DIALYSIS CENTER

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Laboratory Demographics

CLIA Number: 07D2111956

Facility Name: HERALD SQUARE DIALYSIS CENTER

Facility Address:
1 HERALD SQUARE, STE 100
NEW BRITAIN, CT
ZIP 06051
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Facility Phone Number: 860 223-4963

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1467813758

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D2111956
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HERALD SQUARE DIALYSIS CENTER
Street	1 HERALD SQUARE, STE 100
City	NEW BRITAIN
State	CT
ZIP	06051
Phone	860 223-4963
CertificateType	4
CertificateEffectiveDate	4/19/2024
CertificateExpirationDate	4/18/2026
FacilityType	Waiver

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