10D2048733 CLIA NUMBER - DOWNTOWN PENSACOLA DIALYSIS

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Laboratory Demographics

CLIA Number: 10D2048733

Facility Name: DOWNTOWN PENSACOLA DIALYSIS

Facility Address:
700 E CERVANTES ST STE A
PENSACOLA, FL
ZIP 32501
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Facility Phone Number: 850 433-1534

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1639445463

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2048733
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DOWNTOWN PENSACOLA DIALYSIS
Street	700 E CERVANTES ST STE A
City	PENSACOLA
State	FL
ZIP	32501
Phone	850 433-1534
CertificateType	4
CertificateEffectiveDate	10/23/2022
CertificateExpirationDate	10/22/2024
FacilityType	Waiver

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