24D1097824 CLIA NUMBER - FRESENIUS KIDNEY CARE ST CLOUD

Laboratory Demographics

CLIA Number: 24D1097824

Facility Name: FRESENIUS KIDNEY CARE ST CLOUD

Facility Address:
2035 15TH STREET NORTH, SUITE 220
SAINT CLOUD, MN
ZIP 56303
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Facility Phone Number: 320 656-7014

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1710652672

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D1097824
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE ST CLOUD
Street	2035 15TH STREET NORTH, SUITE 220
City	SAINT CLOUD
State	MN
ZIP	56303
Phone	320 656-7014
CertificateType	4
CertificateEffectiveDate	4/3/2023
CertificateExpirationDate	4/2/2025
FacilityType	Waiver

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