14D0716018 CLIA NUMBER - FRESENIUS MEDICAL CARE NORTHCENTER

Laboratory Demographics

CLIA Number: 14D0716018

Facility Name: FRESENIUS MEDICAL CARE NORTHCENTER

Facility Address:
2620 W ADDISON ST
CHICAGO, IL
ZIP 60618
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Facility Phone Number: 773 248-0462

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1215379961

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0716018
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE NORTHCENTER
Street	2620 W ADDISON ST
City	CHICAGO
State	IL
ZIP	60618
Phone	773 248-0462
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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