29D1093485 CLIA NUMBER - LIBERTY DIALYSIS CARSON CITY

Laboratory Demographics

CLIA Number: 29D1093485

Facility Name: LIBERTY DIALYSIS CARSON CITY

Facility Address:
4500 S CARSON STREET
CARSON CITY, NV
ZIP 89701
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Facility Phone Number: 775 461-7250

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1336317098

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	29D1093485
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LIBERTY DIALYSIS CARSON CITY
Street	4500 S CARSON STREET
City	CARSON CITY
State	NV
ZIP	89701
Phone	775 461-7250
CertificateType	4
CertificateEffectiveDate	1/15/2023
CertificateExpirationDate	1/14/2025
FacilityType	Waiver

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