10D2213610 CLIA NUMBER - 71120 VENTURES, LLC

Laboratory Demographics

CLIA Number: 10D2213610

Facility Name: 71120 VENTURES, LLC

Facility Address:
326 DEL PRADO BOULEVARD, NORTH SUITE 101
CAPE CORAL, FL
ZIP 33909
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Facility Phone Number: (239) 689-7854

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1205411154

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2213610
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	71120 VENTURES, LLC
Street	326 DEL PRADO BOULEVARD, NORTH SUITE 101
City	CAPE CORAL
State	FL
ZIP	33909
Phone	(239) 689-7854

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This page was last updated on: 5/11/2023