14D2156196 CLIA NUMBER - FORD CITY DIALYSIS TOTAL RENAL CARE INC

Laboratory Demographics

CLIA Number: 14D2156196

Facility Name: FORD CITY DIALYSIS TOTAL RENAL CARE INC

Facility Address:
8159 S CICERO AVE
CHICAGO, IL
ZIP 60652
Get Directions

Facility Phone Number: 773 735-8820

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1154801702

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2156196
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FORD CITY DIALYSIS TOTAL RENAL CARE INC
Street	8159 S CICERO AVE
City	CHICAGO
State	IL
ZIP	60652
Phone	773 735-8820
CertificateType	4
CertificateEffectiveDate	10/11/2022
CertificateExpirationDate	10/10/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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