10D0914878 CLIA NUMBER - FMC DIALYSIS SERVICES WEST ORLANDO

Laboratory Demographics

CLIA Number: 10D0914878

Facility Name: FMC DIALYSIS SERVICES WEST ORLANDO

Facility Address:
5600 WEST COLONIAL DRIVE STE 101
ORLANDO, FL
ZIP 32808
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Facility Phone Number: 407 297-3777

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1528170388

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0914878
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FMC DIALYSIS SERVICES WEST ORLANDO
Street	5600 WEST COLONIAL DRIVE STE 101
City	ORLANDO
State	FL
ZIP	32808
Phone	407 297-3777
CertificateType	4
CertificateEffectiveDate	5/14/2022
CertificateExpirationDate	5/13/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024