10D0294610 CLIA NUMBER - CHARLOTTE NEPHROLOGY ASSOCIATES PA

Laboratory Demographics

CLIA Number: 10D0294610

Facility Name: CHARLOTTE NEPHROLOGY ASSOCIATES PA

Facility Address:
3300 TAMIAMI TRAIL SUITE 101-A
PORT CHARLOTTE, FL
ZIP 33952
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Facility Phone Number: 941 629-4676

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1831412451

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	10D0294610
LAB Type	Physician Office
Facility Name	CHARLOTTE NEPHROLOGY ASSOCIATES PA
Street	3300 TAMIAMI TRAIL SUITE 101-A
City	PORT CHARLOTTE
State	FL
ZIP	33952
Phone	941 629-4676
CertificateType	4
CertificateEffectiveDate	12/4/2023
CertificateExpirationDate	12/3/2025
FacilityType	Waiver

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