13D1090978 CLIA NUMBER - NAMPA DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 13D1090978

Facility Name: NAMPA DIALYSIS CENTER

Facility Address:
846 PARKCENTRE WAY
NAMPA, ID
ZIP 83651
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Facility Phone Number: 208 467-5180

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1225089915

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D1090978
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NAMPA DIALYSIS CENTER
Street	846 PARKCENTRE WAY
City	NAMPA
State	ID
ZIP	83651
Phone	208 467-5180
CertificateType	4
CertificateEffectiveDate	10/22/2022
CertificateExpirationDate	10/21/2024
FacilityType	Waiver

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