10D0645431 CLIA NUMBER - TAMARAC KIDNEY CENTER

Laboratory Demographics

CLIA Number: 10D0645431

Facility Name: TAMARAC KIDNEY CENTER

Facility Address:
7059 NW 88TH AVENUE
TAMARAC, FL
ZIP 33321
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Facility Phone Number: 954 721-0093

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1689786428

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0645431
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	TAMARAC KIDNEY CENTER
Street	7059 NW 88TH AVENUE
City	TAMARAC
State	FL
ZIP	33321
Phone	954 721-0093
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