10D2145366 CLIA NUMBER - METROWEST DIALYSIS

Laboratory Demographics

CLIA Number: 10D2145366

Facility Name: METROWEST DIALYSIS

Facility Address:
4578 S KIRKMAN ROAD
ORLANDO, FL
ZIP 32811
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Facility Phone Number: 407 298-3977

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1952809758

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2145366
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	METROWEST DIALYSIS
Street	4578 S KIRKMAN ROAD
City	ORLANDO
State	FL
ZIP	32811
Phone	407 298-3977
CertificateType	4
CertificateEffectiveDate	3/6/2024
CertificateExpirationDate	3/5/2026
FacilityType	Waiver

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