10D1050534 CLIA NUMBER - CHIPLEY DIALYSIS

Laboratory Demographics

CLIA Number: 10D1050534

Facility Name: CHIPLEY DIALYSIS

Facility Address:
877 3RD ST STE 2
CHIPLEY, FL
ZIP 32428
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Facility Phone Number: 850 638-7783

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1831155662

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1050534
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CHIPLEY DIALYSIS
Street	877 3RD ST STE 2
City	CHIPLEY
State	FL
ZIP	32428
Phone	850 638-7783
CertificateType	4
CertificateEffectiveDate	2/7/2024
CertificateExpirationDate	2/6/2026
FacilityType	Waiver

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