10D1093254 CLIA NUMBER - FRESENIUS MEDICAL CARE OCEANWAY

Laboratory Demographics

CLIA Number: 10D1093254

Facility Name: FRESENIUS MEDICAL CARE OCEANWAY

Facility Address:
12961 N MAIN ST SUITE 305
JACKSONVILLE, FL
ZIP 32218
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Facility Phone Number: 904 757-7425

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1235398793

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1093254
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE OCEANWAY
Street	12961 N MAIN ST SUITE 305
City	JACKSONVILLE
State	FL
ZIP	32218
Phone	904 757-7425
CertificateType	4
CertificateEffectiveDate	12/15/2022
CertificateExpirationDate	12/14/2024
FacilityType	Waiver

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