10D2004045 CLIA NUMBER - FRESENIUS MEDICAL CARE LAKE CLARKE SHORES DIALYSIS CTR

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Laboratory Demographics

CLIA Number: 10D2004045

Facility Name: FRESENIUS MEDICAL CARE LAKE CLARKE SHORES DIALYSIS CTR

Facility Address:
3047 FOREST HILL BLVD
WEST PALM BEACH, FL
ZIP 33406
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Facility Phone Number: 561 641-9611

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1215269923

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2004045
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE LAKE CLARKE SHORES DIALYSIS CTR
Street	3047 FOREST HILL BLVD
City	WEST PALM BEACH
State	FL
ZIP	33406
Phone	561 641-9611
CertificateType	4
CertificateEffectiveDate	2/24/2024
CertificateExpirationDate	2/23/2026
FacilityType	Waiver

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