33D0967370 CLIA NUMBER - SOUTH BRONX DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 33D0967370

Facility Name: SOUTH BRONX DIALYSIS CENTER

Facility Address:
1940 WEBSTER AVE
BRONX, NY
ZIP 10457
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Facility Phone Number: 718 716-3999

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1932135571

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D0967370
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SOUTH BRONX DIALYSIS CENTER
Street	1940 WEBSTER AVE
City	BRONX
State	NY
ZIP	10457
Phone	718 716-3999
CertificateType	4
CertificateEffectiveDate	11/10/1999
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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