10D0672853 CLIA NUMBER - HALLANDALE DIALYSIS

Laboratory Demographics

CLIA Number: 10D0672853

Facility Name: HALLANDALE DIALYSIS

Facility Address:
2655 HOLLYWOOD BLVD
HOLLYWOOD, FL
ZIP 33020
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Facility Phone Number: 954 925-9909

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1699755355

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0672853
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HALLANDALE DIALYSIS
Street	2655 HOLLYWOOD BLVD
City	HOLLYWOOD
State	FL
ZIP	33020
Phone	954 925-9909
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