10D0989884 CLIA NUMBER - PERRY DIALYSIS

Laboratory Demographics

CLIA Number: 10D0989884

Facility Name: PERRY DIALYSIS

Facility Address:
118 W MAIN
PERRY, FL
ZIP 32347
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Facility Phone Number: 850 584-6012

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1972571206

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0989884
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	PERRY DIALYSIS
Street	118 W MAIN
City	PERRY
State	FL
ZIP	32347
Phone	850 584-6012
CertificateType	4
CertificateEffectiveDate	8/8/2023
CertificateExpirationDate	8/7/2025
FacilityType	Waiver

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