10D2108830 CLIA NUMBER - PALM COAST HOME TRAINING

Laboratory Demographics

CLIA Number: 10D2108830

Facility Name: PALM COAST HOME TRAINING

Facility Address:
80 PINNACLES DR STE 1000
PALM COAST, FL
ZIP 32164
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Facility Phone Number: (615) 320-4214

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1235522103

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2108830
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	PALM COAST HOME TRAINING
Street	80 PINNACLES DR STE 1000
City	PALM COAST
State	FL
ZIP	32164
Phone	(615) 320-4214

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This page was last updated on: 5/11/2023