15D0995149 CLIA NUMBER - FRESENIUS MED CARE FT WAYNE DUPONT

Laboratory Demographics

CLIA Number: 15D0995149

Facility Name: FRESENIUS MED CARE FT WAYNE DUPONT

Facility Address:
10204 E DUPONT CIR DR
FORT WAYNE, IN
ZIP 46825
Get Directions

Facility Phone Number: 260 489-9255

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1770698524

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	15D0995149
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MED CARE FT WAYNE DUPONT
Street	10204 E DUPONT CIR DR
City	FORT WAYNE
State	IN
ZIP	46825
Phone	260 489-9255
CertificateType	4
CertificateEffectiveDate	6/2/2022
CertificateExpirationDate	6/1/2024
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