24D1078979 CLIA NUMBER - FRESENIUS MEDICAL CARE WEST ST PAUL DIALYSIS

Laboratory Demographics

CLIA Number: 24D1078979

Facility Name: FRESENIUS MEDICAL CARE WEST ST PAUL DIALYSIS

Facility Address:
1590 SOUTH ROBERT STREET SUITE 130
WEST SAINT PAUL, MN
ZIP 55118
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Facility Phone Number: 651 457-2232

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1972780161

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D1078979
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE WEST ST PAUL DIALYSIS
Street	1590 SOUTH ROBERT STREET SUITE 130
City	WEST SAINT PAUL
State	MN
ZIP	55118
Phone	651 457-2232
CertificateType	4
CertificateEffectiveDate	1/18/2024
CertificateExpirationDate	1/17/2026
FacilityType	Waiver

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