34D2076843 CLIA NUMBER - BIO-MEDICAL APPLICATION OF NC FMC HICKORY HOME

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Laboratory Demographics

CLIA Number: 34D2076843

Facility Name: BIO-MEDICAL APPLICATION OF NC FMC HICKORY HOME

Facility Address:
1899 TATE BLVD SUITE 2102
HICKORY, NC
ZIP 28602
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Facility Phone Number: 980 254-4563

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1619394962

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2076843
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BIO-MEDICAL APPLICATION OF NC FMC HICKORY HOME
Street	1899 TATE BLVD SUITE 2102
City	HICKORY
State	NC
ZIP	28602
Phone	980 254-4563
CertificateType	4
CertificateEffectiveDate	4/28/2024
CertificateExpirationDate	4/27/2026
FacilityType	Waiver

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