32D0653290 CLIA NUMBER - RENAL CARE GROUP

Laboratory Demographics

CLIA Number: 32D0653290

Facility Name: RENAL CARE GROUP

Facility Address:
3875 FOOTHILLS ROAD
LAS CRUCES, NM
ZIP 88011
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Facility Phone Number: 505 522-5858

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1619037017

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D0653290
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RENAL CARE GROUP
Street	3875 FOOTHILLS ROAD
City	LAS CRUCES
State	NM
ZIP	88011
Phone	505 522-5858
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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