10D0645518 CLIA NUMBER - FMC CLEARWATER BEACH

Laboratory Demographics

CLIA Number: 10D0645518

Facility Name: FMC CLEARWATER BEACH

Facility Address:
1057 S FT HARRISON AVE
CLEARWATER, FL
ZIP 33756
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Facility Phone Number: 727 441-1608

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1437168440

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0645518
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FMC CLEARWATER BEACH
Street	1057 S FT HARRISON AVE
City	CLEARWATER
State	FL
ZIP	33756
Phone	727 441-1608
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