33D2094251 CLIA NUMBER - WILLIAMSBRIDGE HOME DIALYSIS CENTER

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Laboratory Demographics

CLIA Number: 33D2094251

Facility Name: WILLIAMSBRIDGE HOME DIALYSIS CENTER

Facility Address:
3525 WHITE PLAINS RD - SUITE A
BRONX, NY
ZIP 10461
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Facility Phone Number: 718 652-1013

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1528464179

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2094251
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	WILLIAMSBRIDGE HOME DIALYSIS CENTER
Street	3525 WHITE PLAINS RD - SUITE A
City	BRONX
State	NY
ZIP	10461
Phone	718 652-1013
CertificateType	4
CertificateEffectiveDate	4/14/2015
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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