10D2163250 CLIA NUMBER - FRESENIUS MEDICAL CARE FOUR CORNERS LLC

Laboratory Demographics

CLIA Number: 10D2163250

Facility Name: FRESENIUS MEDICAL CARE FOUR CORNERS LLC

Facility Address:
503 CAGEN VIEW ROAD SUITE 300
CLERMONT, FL
ZIP 34714
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Facility Phone Number: 352 394-3003

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1477017515

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2163250
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE FOUR CORNERS LLC
Street	503 CAGEN VIEW ROAD SUITE 300
City	CLERMONT
State	FL
ZIP	34714
Phone	352 394-3003
CertificateType	4
CertificateEffectiveDate	3/11/2023
CertificateExpirationDate	3/10/2025
FacilityType	Waiver

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