09D0987742 CLIA NUMBER - LEE STREET DIALYSIS

Laboratory Demographics

CLIA Number: 09D0987742

Facility Name: LEE STREET DIALYSIS

Facility Address:
5155 LEE ST NE
WASHINGTON, DC
ZIP 20019
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Facility Phone Number: 253 272-1916

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1609842889

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	09D0987742
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LEE STREET DIALYSIS
Street	5155 LEE ST NE
City	WASHINGTON
State	DC
ZIP	20019
Phone	253 272-1916
CertificateType	4
CertificateEffectiveDate	6/13/2023
CertificateExpirationDate	6/12/2025
FacilityType	Waiver

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