32D1071582 CLIA NUMBER - DIALYSIS CLINIC INC

Laboratory Demographics

CLIA Number: 32D1071582

Facility Name: DIALYSIS CLINIC INC

Facility Address:
905 LOUISIANA NE
ALBUQUERQUE, NM
ZIP 87110
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Facility Phone Number: 505 254-1800

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1275747735

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D1071582
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CLINIC INC
Street	905 LOUISIANA NE
City	ALBUQUERQUE
State	NM
ZIP	87110
Phone	505 254-1800
CertificateType	4
CertificateEffectiveDate	7/30/2023
CertificateExpirationDate	7/29/2025
FacilityType	Waiver

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