10D2211376 CLIA NUMBER - 71020 VENTURES, LLC DBA US RENAL CARE CAPE CORAL NORTH DIALYSIS

Laboratory Demographics

CLIA Number: 10D2211376

Facility Name: 71020 VENTURES, LLC DBA US RENAL CARE CAPE CORAL NORTH DIALYSIS

Facility Address:
3571 DEL PRADO BOULEVARD NORTH UNIT 11
CAPE CORAL, FL
ZIP 33904
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Facility Phone Number: 239 689-7757

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1598346777

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2211376
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	71020 VENTURES, LLC DBA US RENAL CARE CAPE CORAL NORTH DIALYSIS
Street	3571 DEL PRADO BOULEVARD NORTH UNIT 11
City	CAPE CORAL
State	FL
ZIP	33904
Phone	239 689-7757
CertificateType	4
CertificateEffectiveDate	1/27/2023
CertificateExpirationDate	1/26/2025
FacilityType	Waiver

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