10D0683927 CLIA NUMBER - PLANTATION DIALYSIS

Laboratory Demographics

CLIA Number: 10D0683927

Facility Name: PLANTATION DIALYSIS

Facility Address:
7061 CYPRESS RD STE 103
PLANTATION, FL
ZIP 33317
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Facility Phone Number: 954 583-2100

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1124096458

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0683927
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	PLANTATION DIALYSIS
Street	7061 CYPRESS RD STE 103
City	PLANTATION
State	FL
ZIP	33317
Phone	954 583-2100
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