07D2223367 CLIA NUMBER - LONG RIDGE DIALYSIS

Laboratory Demographics

CLIA Number: 07D2223367

Facility Name: LONG RIDGE DIALYSIS

Facility Address:
260 LONG RIDGE RD
STAMFORD, CT
ZIP 06927
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Facility Phone Number: 475 477-5557

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1215503156

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	07D2223367
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LONG RIDGE DIALYSIS
Street	260 LONG RIDGE RD
City	STAMFORD
State	CT
ZIP	06927
Phone	475 477-5557
CertificateType	4
CertificateEffectiveDate	5/6/2023
CertificateExpirationDate	5/5/2025
FacilityType	Waiver

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