33D2190822 CLIA NUMBER - BRONX CENTER FOR RENAL DIALYSIS LLC DBA AIRMONT CENTER FOR RENAL DIALYSIS

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Laboratory Demographics

CLIA Number: 33D2190822

Facility Name: BRONX CENTER FOR RENAL DIALYSIS LLC DBA AIRMONT CENTER FOR RENAL DIALYSIS

Facility Address:
4 S AIRMONT RD
SUFFERN, NY
ZIP 10901
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Facility Phone Number: 845 442-0500

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1265070171

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2190822
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BRONX CENTER FOR RENAL DIALYSIS LLC DBA AIRMONT CENTER FOR RENAL DIALYSIS
Street	4 S AIRMONT RD
City	SUFFERN
State	NY
ZIP	10901
Phone	845 442-0500
CertificateType	4
CertificateEffectiveDate	8/19/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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