10D0289232 CLIA NUMBER - BRANDON ARTIFICIAL KIDNEY CENTER

Laboratory Demographics

CLIA Number: 10D0289232

Facility Name: BRANDON ARTIFICIAL KIDNEY CENTER

Facility Address:
514 MEDICAL OAKS AVE
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 661-3815

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1881706638

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0289232
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BRANDON ARTIFICIAL KIDNEY CENTER
Street	514 MEDICAL OAKS AVE
City	BRANDON
State	FL
ZIP	33511
Phone	813 661-3815
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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