26D2137979 CLIA NUMBER - NORTH COUNTY DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 26D2137979

Facility Name: NORTH COUNTY DIALYSIS CENTER

Facility Address:
272 MAYFAIR PLAZA
SAINT LOUIS, MO
ZIP 63033
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Facility Phone Number: 314 859-1234

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1942710991

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D2137979
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NORTH COUNTY DIALYSIS CENTER
Street	272 MAYFAIR PLAZA
City	SAINT LOUIS
State	MO
ZIP	63033
Phone	314 859-1234
CertificateType	4
CertificateEffectiveDate	4/12/2023
CertificateExpirationDate	4/11/2025
FacilityType	Waiver

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