36D2107543 CLIA NUMBER - COLUMBUS MED PARTNERS LLC DBA LIBERTY DIALYSIS WEST COLUMBUS

Laboratory Demographics

CLIA Number: 36D2107543

Facility Name: COLUMBUS MED PARTNERS LLC DBA LIBERTY DIALYSIS WEST COLUMBUS

Facility Address:
4500 WEST BROAD STREET
COLUMBUS, OH
ZIP 43228
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Facility Phone Number: 614 853-5995

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1891986428

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2107543
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	COLUMBUS MED PARTNERS LLC DBA LIBERTY DIALYSIS WEST COLUMBUS
Street	4500 WEST BROAD STREET
City	COLUMBUS
State	OH
ZIP	43228
Phone	614 853-5995
CertificateType	4
CertificateEffectiveDate	1/15/2024
CertificateExpirationDate	1/14/2026
FacilityType	Waiver

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