19D0465103 CLIA NUMBER - NATCHITOCHES DIALYSIS FACILITY

Laboratory Demographics

CLIA Number: 19D0465103

Facility Name: NATCHITOCHES DIALYSIS FACILITY

Facility Address:
700 KEYSER AVE
NATCHITOCHES, LA
ZIP 71457
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Facility Phone Number: 318 352-1960

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1154433902

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D0465103
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NATCHITOCHES DIALYSIS FACILITY
Street	700 KEYSER AVE
City	NATCHITOCHES
State	LA
ZIP	71457
Phone	318 352-1960
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