10D2103224 CLIA NUMBER - FRESENIUS MEDICAL CARE AUBURNDALE DIALYSIS CLINIC

Laboratory Demographics

CLIA Number: 10D2103224

Facility Name: FRESENIUS MEDICAL CARE AUBURNDALE DIALYSIS CLINIC

Facility Address:
365 HAVENDALE BLVD STE 4
AUBURNDALE, FL
ZIP 33823
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Facility Phone Number: 863 551-3159

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1386010130

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2103224
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE AUBURNDALE DIALYSIS CLINIC
Street	365 HAVENDALE BLVD STE 4
City	AUBURNDALE
State	FL
ZIP	33823
Phone	863 551-3159
CertificateType	4
CertificateEffectiveDate	10/8/2023
CertificateExpirationDate	10/7/2025
FacilityType	Waiver

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