36D1006351 CLIA NUMBER - RENAL CARE GROUP - YOUNGSTOWN

Laboratory Demographics

CLIA Number: 36D1006351

Facility Name: RENAL CARE GROUP - YOUNGSTOWN

Facility Address:
1340 BELMONT AVENUE SUITE 2100
YOUNGSTOWN, OH
ZIP 44504
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Facility Phone Number: 330 746-2860

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1376971945

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D1006351
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RENAL CARE GROUP - YOUNGSTOWN
Street	1340 BELMONT AVENUE SUITE 2100
City	YOUNGSTOWN
State	OH
ZIP	44504
Phone	330 746-2860
CertificateType	4
CertificateEffectiveDate	11/14/2022
CertificateExpirationDate	11/13/2024
FacilityType	Waiver

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