14D0716022 CLIA NUMBER - FRESENIUS MED CARE NORTH KILPATRICK JV

Laboratory Demographics

CLIA Number: 14D0716022

Facility Name: FRESENIUS MED CARE NORTH KILPATRICK JV

Facility Address:
4800 N KILPATRICK
CHICAGO, IL
ZIP 60630
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Facility Phone Number: 773 545-3693

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1851723803

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0716022
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MED CARE NORTH KILPATRICK JV
Street	4800 N KILPATRICK
City	CHICAGO
State	IL
ZIP	60630
Phone	773 545-3693
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