09D1014718 CLIA NUMBER - GEORGETOWN HOME TRAINING

Laboratory Demographics

CLIA Number: 09D1014718

Facility Name: GEORGETOWN HOME TRAINING

Facility Address:
2233 WISCONSIN AVE NW STE 215
WASHINGTON, DC
ZIP 20007
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Facility Phone Number: 202 337-1431

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1386610558

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	09D1014718
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	GEORGETOWN HOME TRAINING
Street	2233 WISCONSIN AVE NW STE 215
City	WASHINGTON
State	DC
ZIP	20007
Phone	202 337-1431
CertificateType	4
CertificateEffectiveDate	7/15/2023
CertificateExpirationDate	7/14/2025
FacilityType	Waiver

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