36D2127300 CLIA NUMBER - LAWRENCE COUNTY DIALYSIS

Laboratory Demographics

CLIA Number: 36D2127300

Facility Name: LAWRENCE COUNTY DIALYSIS

Facility Address:
367 COUNTY RD 406, UNIT 11
SOUTH POINT, OH
ZIP 45680
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Facility Phone Number: 740 894-0830

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1235676677

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2127300
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LAWRENCE COUNTY DIALYSIS
Street	367 COUNTY RD 406, UNIT 11
City	SOUTH POINT
State	OH
ZIP	45680
Phone	740 894-0830
CertificateType	4
CertificateEffectiveDate	3/13/2023
CertificateExpirationDate	3/12/2025
FacilityType	Waiver

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