14D1002106 CLIA NUMBER - FRESENIUS MEDICAL CARE ROUND LAKE

Laboratory Demographics

CLIA Number: 14D1002106

Facility Name: FRESENIUS MEDICAL CARE ROUND LAKE

Facility Address:
401 WEST NIPPERSINK ROAD
ROUND LAKE, IL
ZIP 60073
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Facility Phone Number: 847 740-5281

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1578958435

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1002106
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE ROUND LAKE
Street	401 WEST NIPPERSINK ROAD
City	ROUND LAKE
State	IL
ZIP	60073
Phone	847 740-5281
CertificateType	4
CertificateEffectiveDate	2/24/2024
CertificateExpirationDate	2/23/2026
FacilityType	Waiver

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