10D2015979 CLIA NUMBER - CAPE CORAL NORTH DIALYSIS

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Laboratory Demographics

CLIA Number: 10D2015979

Facility Name: CAPE CORAL NORTH DIALYSIS

Facility Address:
1315 SE 8TH TERR
CAPE CORAL, FL
ZIP 33990
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Facility Phone Number: 239 772-5600

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1134196637

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2015979
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CAPE CORAL NORTH DIALYSIS
Street	1315 SE 8TH TERR
City	CAPE CORAL
State	FL
ZIP	33990
Phone	239 772-5600
CertificateType	4
CertificateEffectiveDate	11/9/2022
CertificateExpirationDate	11/8/2024
FacilityType	Waiver

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