10D0867482 CLIA NUMBER - MANATEE KIDNEY DISEASES CONSULTANTS

Laboratory Demographics

CLIA Number: 10D0867482

Facility Name: MANATEE KIDNEY DISEASES CONSULTANTS

Facility Address:
3701 MANATEE AVE W
BRADENTON, FL
ZIP 34205
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Facility Phone Number: 941 746-5840

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1043335813

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	10D0867482
LAB Type	Physician Office
Facility Name	MANATEE KIDNEY DISEASES CONSULTANTS
Street	3701 MANATEE AVE W
City	BRADENTON
State	FL
ZIP	34205
Phone	941 746-5840
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