33D2041560 CLIA NUMBER - MOHAWK VALLEY DIALYSIS CENTER INC

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Laboratory Demographics

CLIA Number: 33D2041560

Facility Name: MOHAWK VALLEY DIALYSIS CENTER INC

Facility Address:
115 TOWNE SQUARE DRIVE
AMSTERDAM, NY
ZIP 12010
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Facility Phone Number: 518 627-0280

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1750642971

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2041560
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	MOHAWK VALLEY DIALYSIS CENTER INC
Street	115 TOWNE SQUARE DRIVE
City	AMSTERDAM
State	NY
ZIP	12010
Phone	518 627-0280
CertificateType	4
CertificateEffectiveDate	5/24/2012
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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