17D2118573 CLIA NUMBER - HOPEFIELD DIALYSIS

Laboratory Demographics

CLIA Number: 17D2118573

Facility Name: HOPEFIELD DIALYSIS

Facility Address:
2425 S ROUSE ST
PITTSBURG, KS
ZIP 66762
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Facility Phone Number: 620 231-0656

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1558725259

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D2118573
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HOPEFIELD DIALYSIS
Street	2425 S ROUSE ST
City	PITTSBURG
State	KS
ZIP	66762
Phone	620 231-0656
CertificateType	4
CertificateEffectiveDate	9/12/2022
CertificateExpirationDate	9/11/2024
FacilityType	Waiver

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