10D1005984 CLIA NUMBER - FMC DIALYSIS SERVICES NORTH BOYNTON BEACH

Laboratory Demographics

CLIA Number: 10D1005984

Facility Name: FMC DIALYSIS SERVICES NORTH BOYNTON BEACH

Facility Address:
4965 LE CHALET BLVD
BOYNTON BEACH, FL
ZIP 33436
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Facility Phone Number: 561 734-5585

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1336251172

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1005984
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FMC DIALYSIS SERVICES NORTH BOYNTON BEACH
Street	4965 LE CHALET BLVD
City	BOYNTON BEACH
State	FL
ZIP	33436
Phone	561 734-5585
CertificateType	4
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Waiver

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