10D2083264 CLIA NUMBER - DUNN AVENUE DIALYSIS

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Laboratory Demographics

CLIA Number: 10D2083264

Facility Name: DUNN AVENUE DIALYSIS

Facility Address:
1215 DUNN AVE STE 8
JACKSONVILLE, FL
ZIP 32218
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Facility Phone Number: 904 757-3540

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1023424694

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2083264
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DUNN AVENUE DIALYSIS
Street	1215 DUNN AVE STE 8
City	JACKSONVILLE
State	FL
ZIP	32218
Phone	904 757-3540
CertificateType	4
CertificateEffectiveDate	9/2/2022
CertificateExpirationDate	9/1/2024
FacilityType	Waiver

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