31D2132934 CLIA NUMBER - USRC PENNS GROVE LLC DBA US RENAL CARE PENNS GROVE DIALYSIS

Laboratory Demographics

CLIA Number: 31D2132934

Facility Name: USRC PENNS GROVE LLC DBA US RENAL CARE PENNS GROVE DIALYSIS

Facility Address:
1 COLLINS DRIVE
CARNEYS POINT, NJ
ZIP 08069
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Facility Phone Number: 856 221-8131

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1366983819

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2132934
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	USRC PENNS GROVE LLC DBA US RENAL CARE PENNS GROVE DIALYSIS
Street	1 COLLINS DRIVE
City	CARNEYS POINT
State	NJ
ZIP	08069
Phone	856 221-8131
CertificateType	4
CertificateEffectiveDate	6/30/2023
CertificateExpirationDate	6/29/2025
FacilityType	Waiver

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