32D1085598 CLIA NUMBER - FRESENIUS MEDICAL CARE CLEARANCEWATER LLC

Laboratory Demographics

CLIA Number: 32D1085598

Facility Name: FRESENIUS MEDICAL CARE CLEARANCEWATER LLC

Facility Address:
7555 ENCHANTED HILLS BLVD NE SUITE 102
RIO RANCHO, NM
ZIP 87144
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Facility Phone Number: 505 771-0316

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1396990263

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D1085598
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE CLEARANCEWATER LLC
Street	7555 ENCHANTED HILLS BLVD NE SUITE 102
City	RIO RANCHO
State	NM
ZIP	87144
Phone	505 771-0316
CertificateType	4
CertificateEffectiveDate	6/23/2022
CertificateExpirationDate	6/22/2024
FacilityType	Waiver

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