10D2031257 CLIA NUMBER - CROWN DIALYSIS CENTER OF PALM BEACH LLC

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Laboratory Demographics

CLIA Number: 10D2031257

Facility Name: CROWN DIALYSIS CENTER OF PALM BEACH LLC

Facility Address:
4701 N FEDERAL HWY
BOCA RATON, FL
ZIP 33431
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Facility Phone Number: 561 372-3700

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1750660247

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2031257
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CROWN DIALYSIS CENTER OF PALM BEACH LLC
Street	4701 N FEDERAL HWY
City	BOCA RATON
State	FL
ZIP	33431
Phone	561 372-3700
CertificateType	4
CertificateEffectiveDate	10/17/2023
CertificateExpirationDate	10/16/2025
FacilityType	Waiver

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