14D2030607 CLIA NUMBER - FRESENIUS MEDICAL CARE MUNDELEIN

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Laboratory Demographics

CLIA Number: 14D2030607

Facility Name: FRESENIUS MEDICAL CARE MUNDELEIN

Facility Address:
1402 TOWNLINE RD
MUNDELEIN, IL
ZIP 60060
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Facility Phone Number: 847 949-3904

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1760761316

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2030607
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE MUNDELEIN
Street	1402 TOWNLINE RD
City	MUNDELEIN
State	IL
ZIP	60060
Phone	847 949-3904
CertificateType	4
CertificateEffectiveDate	9/30/2023
CertificateExpirationDate	9/29/2025
FacilityType	Waiver

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