19D2091302 CLIA NUMBER - FRESENIUS MEDICAL CARE LAKE FOREST, LLC

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Laboratory Demographics

CLIA Number: 19D2091302

Facility Name: FRESENIUS MEDICAL CARE LAKE FOREST, LLC

Facility Address:
10545 LAKE FOREST BLVD
NEW ORLEANS, LA
ZIP 70127
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Facility Phone Number: 504 248-4910

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1689078347

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2091302
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE LAKE FOREST, LLC
Street	10545 LAKE FOREST BLVD
City	NEW ORLEANS
State	LA
ZIP	70127
Phone	504 248-4910
CertificateType	4
CertificateEffectiveDate	2/10/2023
CertificateExpirationDate	2/9/2025
FacilityType	Waiver

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