10D1058055 CLIA NUMBER - UNIVERSAL KIDNEY CENTER OF PEMBROKE PINES-MIRAMAR LLC

Laboratory Demographics

CLIA Number: 10D1058055

Facility Name: UNIVERSAL KIDNEY CENTER OF PEMBROKE PINES-MIRAMAR LLC

Facility Address:
18004 NW 6TH ST #102
PEMBROKE PINES, FL
ZIP 33029
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Facility Phone Number: 954 433-9400

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1215959184

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1058055
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	UNIVERSAL KIDNEY CENTER OF PEMBROKE PINES-MIRAMAR LLC
Street	18004 NW 6TH ST #102
City	PEMBROKE PINES
State	FL
ZIP	33029
Phone	954 433-9400
CertificateType	4
CertificateEffectiveDate	8/29/2022
CertificateExpirationDate	8/28/2024
FacilityType	Waiver

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