10D2211577 CLIA NUMBER - 70720 PARTNERS, LLC DBA US RENAL CARE FORT MYERS SOUTH DIALYSIS

Laboratory Demographics

CLIA Number: 10D2211577

Facility Name: 70720 PARTNERS, LLC DBA US RENAL CARE FORT MYERS SOUTH DIALYSIS

Facility Address:
6800 SHOPPES AT PLANTATION DR - STE 100
FORT MYERS, FL
ZIP 33912
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Facility Phone Number: 239 310-5470

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1477133072

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2211577
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	70720 PARTNERS, LLC DBA US RENAL CARE FORT MYERS SOUTH DIALYSIS
Street	6800 SHOPPES AT PLANTATION DR - STE 100
City	FORT MYERS
State	FL
ZIP	33912
Phone	239 310-5470
CertificateType	4
CertificateEffectiveDate	1/28/2023
CertificateExpirationDate	1/27/2025
FacilityType	Waiver

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