26D2113142 CLIA NUMBER - FRESENIUS MEDICAL CARE ST LOUIS NORTHEAST

Laboratory Demographics

CLIA Number: 26D2113142

Facility Name: FRESENIUS MEDICAL CARE ST LOUIS NORTHEAST

Facility Address:
2840 TARGET DRIVE
SAINT LOUIS, MO
ZIP 63136
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Facility Phone Number: 314 355-1322

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1073986675

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D2113142
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE ST LOUIS NORTHEAST
Street	2840 TARGET DRIVE
City	SAINT LOUIS
State	MO
ZIP	63136
Phone	314 355-1322
CertificateType	4
CertificateEffectiveDate	5/17/2022
CertificateExpirationDate	5/16/2024
FacilityType	Waiver

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