10D0299186 CLIA NUMBER - RAI OHIO AVE FORT PIERCE

Laboratory Demographics

CLIA Number: 10D0299186

Facility Name: RAI OHIO AVE FORT PIERCE

Facility Address:
2501 OHIO AVE
FORT PIERCE, FL
ZIP 34947
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Facility Phone Number: 772 465-6551

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1346259330

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0299186
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RAI OHIO AVE FORT PIERCE
Street	2501 OHIO AVE
City	FORT PIERCE
State	FL
ZIP	34947
Phone	772 465-6551
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