10D2299302 CLIA NUMBER - KIDNEY CARE OF LABELLE LLC

Laboratory Demographics

CLIA Number: 10D2299302

Facility Name: KIDNEY CARE OF LABELLE LLC

Facility Address:
50 N BRIDGE ST STE 200
LABELLE, FL
ZIP 33935
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Facility Phone Number: 863 339-7030

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1306616404

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2299302
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	KIDNEY CARE OF LABELLE LLC
Street	50 N BRIDGE ST STE 200
City	LABELLE
State	FL
ZIP	33935
Phone	863 339-7030
CertificateType	4
CertificateEffectiveDate	2/16/2024
CertificateExpirationDate	2/15/2026
FacilityType	Waiver

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