31D2133294 CLIA NUMBER - HAMILTON STREET DIALYSIS

Laboratory Demographics

CLIA Number: 31D2133294

Facility Name: HAMILTON STREET DIALYSIS

Facility Address:
920 HAMILTON STREET, SUITE C-3
SOMERSET, NJ
ZIP 08873
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Facility Phone Number: 732 220-1593

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1124568563

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	31D2133294
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HAMILTON STREET DIALYSIS
Street	920 HAMILTON STREET, SUITE C-3
City	SOMERSET
State	NJ
ZIP	08873
Phone	732 220-1593
CertificateType	4
CertificateEffectiveDate	7/10/2023
CertificateExpirationDate	7/9/2025
FacilityType	Waiver

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