36D2059714 CLIA NUMBER - KIDNEY CENTER OF BRUNSWICK

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Laboratory Demographics

CLIA Number: 36D2059714

Facility Name: KIDNEY CENTER OF BRUNSWICK

Facility Address:
3812 CENTER RD STE 101
BRUNSWICK, OH
ZIP 44212
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Facility Phone Number: 330 220-4502

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1598006959

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2059714
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	KIDNEY CENTER OF BRUNSWICK
Street	3812 CENTER RD STE 101
City	BRUNSWICK
State	OH
ZIP	44212
Phone	330 220-4502
CertificateType	4
CertificateEffectiveDate	5/29/2023
CertificateExpirationDate	5/28/2025
FacilityType	Waiver

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