26D0437697 CLIA NUMBER - ST LOUIS REGIONAL DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 26D0437697

Facility Name: ST LOUIS REGIONAL DIALYSIS CENTER

Facility Address:
10951 ST CHARLES ROCK ROAD
SAINT ANN, MO
ZIP 63074
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Facility Phone Number: 314 739-4691

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1922110808

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D0437697
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ST LOUIS REGIONAL DIALYSIS CENTER
Street	10951 ST CHARLES ROCK ROAD
City	SAINT ANN
State	MO
ZIP	63074
Phone	314 739-4691
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