16D0939737 CLIA NUMBER - SIOUXLAND DIALYSIS

Laboratory Demographics

CLIA Number: 16D0939737

Facility Name: SIOUXLAND DIALYSIS

Facility Address:
2530 GLENN AVENUE
SIOUX CITY, IA
ZIP 51106
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Facility Phone Number: 712 266-1000

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1609981448

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D0939737
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SIOUXLAND DIALYSIS
Street	2530 GLENN AVENUE
City	SIOUX CITY
State	IA
ZIP	51106
Phone	712 266-1000
CertificateType	4
CertificateEffectiveDate	1/30/2024
CertificateExpirationDate	1/29/2026
FacilityType	Waiver

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