17D0648260 CLIA NUMBER - RENAL CARE GROUP CHANUTE

Laboratory Demographics

CLIA Number: 17D0648260

Facility Name: RENAL CARE GROUP CHANUTE

Facility Address:
703 S PLUMMER AVE
CHANUTE, KS
ZIP 66720
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Facility Phone Number: 620 431-1239

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1437435526

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D0648260
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RENAL CARE GROUP CHANUTE
Street	703 S PLUMMER AVE
City	CHANUTE
State	KS
ZIP	66720
Phone	620 431-1239
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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