34D2167350 CLIA NUMBER - KENLY DIALYSIS

Laboratory Demographics

CLIA Number: 34D2167350

Facility Name: KENLY DIALYSIS

Facility Address:
9266 US HIGHWAY 301 SOUTH
KENLY, NC
ZIP 27542
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Facility Phone Number: 919 284-1714

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1780147207

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2167350
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	KENLY DIALYSIS
Street	9266 US HIGHWAY 301 SOUTH
City	KENLY
State	NC
ZIP	27542
Phone	919 284-1714
CertificateType	4
CertificateEffectiveDate	6/6/2023
CertificateExpirationDate	6/5/2025
FacilityType	Waiver

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