33D2144780 CLIA NUMBER - BRONX RIVER DIALYSIS

Laboratory Demographics

CLIA Number: 33D2144780

Facility Name: BRONX RIVER DIALYSIS

Facility Address:
1616 BRONXDALE AVE
BRONX, NY
ZIP 10462
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Facility Phone Number: 718 430-9800

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1538103494

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2144780
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BRONX RIVER DIALYSIS
Street	1616 BRONXDALE AVE
City	BRONX
State	NY
ZIP	10462
Phone	718 430-9800
CertificateType	4
CertificateEffectiveDate	2/23/2018
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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