33D2161143 CLIA NUMBER - MOUNT EDEN DIALYSIS

Laboratory Demographics

CLIA Number: 33D2161143

Facility Name: MOUNT EDEN DIALYSIS

Facility Address:
1490 MACOMBS RD
BRONX, NY
ZIP 10452
Get Directions

Facility Phone Number: 718 588-2347

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1063911659

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2161143
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	MOUNT EDEN DIALYSIS
Street	1490 MACOMBS RD
City	BRONX
State	NY
ZIP	10452
Phone	718 588-2347
CertificateType	4
CertificateEffectiveDate	1/28/2019
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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