34D0938579 CLIA NUMBER - DIALYSIS NEWCO, LLC DBA US RENAL CARE GLENWATER DIALYSIS

Laboratory Demographics

CLIA Number: 34D0938579

Facility Name: DIALYSIS NEWCO, LLC DBA US RENAL CARE GLENWATER DIALYSIS

Facility Address:
9030 GLENWATER DRIVE
CHARLOTTE, NC
ZIP 28262
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Facility Phone Number: 704 503-6900

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1689940108

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D0938579
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS NEWCO, LLC DBA US RENAL CARE GLENWATER DIALYSIS
Street	9030 GLENWATER DRIVE
City	CHARLOTTE
State	NC
ZIP	28262
Phone	704 503-6900
CertificateType	4
CertificateEffectiveDate	1/12/2024
CertificateExpirationDate	1/11/2026
FacilityType	Waiver

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