33D2101949 CLIA NUMBER - FREEDOM CENTER OF QUEENS

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Laboratory Demographics

CLIA Number: 33D2101949

Facility Name: FREEDOM CENTER OF QUEENS

Facility Address:
176-35 UNION TURNPIKE
FRESH MEADOWS, NY
ZIP 11366
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Facility Phone Number: 718 969-3293

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1760959142

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2101949
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FREEDOM CENTER OF QUEENS
Street	176-35 UNION TURNPIKE
City	FRESH MEADOWS
State	NY
ZIP	11366
Phone	718 969-3293
CertificateType	4
CertificateEffectiveDate	5/2/2018
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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