16D2120807 CLIA NUMBER - FRESENIUS MEDICAL CARE- DAVENPORT

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Laboratory Demographics

CLIA Number: 16D2120807

Facility Name: FRESENIUS MEDICAL CARE- DAVENPORT

Facility Address:
120 WEST LOCUST STREET
DAVENPORT, IA
ZIP 52803
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Facility Phone Number: 563 323-3300

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1093175457

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D2120807
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE- DAVENPORT
Street	120 WEST LOCUST STREET
City	DAVENPORT
State	IA
ZIP	52803
Phone	563 323-3300
CertificateType	4
CertificateEffectiveDate	10/25/2022
CertificateExpirationDate	10/24/2024
FacilityType	Waiver

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