14D2211877 CLIA NUMBER - FRESENIUS KIDNEY CARE SURF ROAD HOME DIALYSIS

Laboratory Demographics

CLIA Number: 14D2211877

Facility Name: FRESENIUS KIDNEY CARE SURF ROAD HOME DIALYSIS

Facility Address:
2845 N SHERIDAN ROAD - STE 703
CHICAGO, IL
ZIP 60657
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Facility Phone Number: 773 525-3053

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1790371698

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2211877
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE SURF ROAD HOME DIALYSIS
Street	2845 N SHERIDAN ROAD - STE 703
City	CHICAGO
State	IL
ZIP	60657
Phone	773 525-3053
CertificateType	4
CertificateEffectiveDate	2/1/2023
CertificateExpirationDate	1/31/2025
FacilityType	Waiver

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