10D1043113 CLIA NUMBER - DSI SOUTH TAMPA, LLC DBA US RENAL CARE SOUTH TAMPA DIALYSIS

Laboratory Demographics

CLIA Number: 10D1043113

Facility Name: DSI SOUTH TAMPA, LLC DBA US RENAL CARE SOUTH TAMPA DIALYSIS

Facility Address:
731 W LUMSDEN RD
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 661-7474

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1679511729

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1043113
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DSI SOUTH TAMPA, LLC DBA US RENAL CARE SOUTH TAMPA DIALYSIS
Street	731 W LUMSDEN RD
City	BRANDON
State	FL
ZIP	33511
Phone	813 661-7474
CertificateType	4
CertificateEffectiveDate	7/18/2023
CertificateExpirationDate	7/17/2025
FacilityType	Waiver

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