32D2145853 CLIA NUMBER - DIALYSIS CLINIC INC - WEST

Laboratory Demographics

CLIA Number: 32D2145853

Facility Name: DIALYSIS CLINIC INC - WEST

Facility Address:
8121 CENTRAL AVE NW
ALBUQUERQUE, NM
ZIP 87121
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Facility Phone Number: 505 836-8644

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1710406301

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D2145853
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CLINIC INC - WEST
Street	8121 CENTRAL AVE NW
City	ALBUQUERQUE
State	NM
ZIP	87121
Phone	505 836-8644
CertificateType	4
CertificateEffectiveDate	3/16/2024
CertificateExpirationDate	3/15/2026
FacilityType	Waiver

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