33D1020582 CLIA NUMBER - ST ALBANS DIALYSIS CENTER

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Laboratory Demographics

CLIA Number: 33D1020582

Facility Name: ST ALBANS DIALYSIS CENTER

Facility Address:
172-70 BAISLEY BLVD
JAMAICA, NY
ZIP 11434
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Facility Phone Number: 718 949-1600

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1508988213

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D1020582
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ST ALBANS DIALYSIS CENTER
Street	172-70 BAISLEY BLVD
City	JAMAICA
State	NY
ZIP	11434
Phone	718 949-1600
CertificateType	4
CertificateEffectiveDate	3/15/2007
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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