33D2273759 CLIA NUMBER - ST JOSEPH'S DIALYSIS - CAMILLUS

Laboratory Demographics

CLIA Number: 33D2273759

Facility Name: ST JOSEPH'S DIALYSIS - CAMILLUS

Facility Address:
5101 W GENESEE ST
CAMILLUS, NY
ZIP 13031
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Facility Phone Number: 315 488-2979

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1548407943

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2273759
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ST JOSEPH'S DIALYSIS - CAMILLUS
Street	5101 W GENESEE ST
City	CAMILLUS
State	NY
ZIP	13031
Phone	315 488-2979
CertificateType	4
CertificateEffectiveDate	12/19/2022
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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