14D2160328 CLIA NUMBER - BRICKYARD DIALYSIS

Laboratory Demographics

CLIA Number: 14D2160328

Facility Name: BRICKYARD DIALYSIS

Facility Address:
2640 N NARRAGANSETT AVE - STE D8
CHICAGO, IL
ZIP 60639
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Facility Phone Number: (773) 622-6345

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1487139085

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2160328
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	BRICKYARD DIALYSIS
Street	2640 N NARRAGANSETT AVE - STE D8
City	CHICAGO
State	IL
ZIP	60639
Phone	(773) 622-6345

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This page was last updated on: 5/11/2023