14D1097209 CLIA NUMBER - FRESENIUS MEDICAL CARE OF MOKENA

Laboratory Demographics

CLIA Number: 14D1097209

Facility Name: FRESENIUS MEDICAL CARE OF MOKENA

Facility Address:
8910 W 192ND STREET, SUITE A & B
MOKENA, IL
ZIP 60448
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Facility Phone Number: 708 478-1815

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1942496120

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1097209
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE OF MOKENA
Street	8910 W 192ND STREET, SUITE A & B
City	MOKENA
State	IL
ZIP	60448
Phone	708 478-1815
CertificateType	4
CertificateEffectiveDate	3/20/2023
CertificateExpirationDate	3/19/2025
FacilityType	Waiver

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