10D2179828 CLIA NUMBER - DIALYSIS CLINIC INC

Laboratory Demographics

CLIA Number: 10D2179828

Facility Name: DIALYSIS CLINIC INC

Facility Address:
1400 NE WALDO RD
GAINESVILLE, FL
ZIP 32641
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Facility Phone Number: 352 415-8330

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1417581810

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2179828
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CLINIC INC
Street	1400 NE WALDO RD
City	GAINESVILLE
State	FL
ZIP	32641
Phone	352 415-8330
CertificateType	4
CertificateEffectiveDate	3/3/2024
CertificateExpirationDate	3/2/2026
FacilityType	Waiver

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