19D2017112 CLIA NUMBER - FRESENIUS KIDNEY CARE EAST HOUMA

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Laboratory Demographics

CLIA Number: 19D2017112

Facility Name: FRESENIUS KIDNEY CARE EAST HOUMA

Facility Address:
707 GRAND CAILLOU RD
HOUMA, LA
ZIP 70363
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Facility Phone Number: 985 262-4143

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1215475868

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2017112
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE EAST HOUMA
Street	707 GRAND CAILLOU RD
City	HOUMA
State	LA
ZIP	70363
Phone	985 262-4143
CertificateType	4
CertificateEffectiveDate	12/3/2022
CertificateExpirationDate	12/2/2024
FacilityType	Waiver

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