36D2298359 CLIA NUMBER - INDEPENDENT DIALYSIS GROUP NORTHEAST OHIO

Laboratory Demographics

CLIA Number: 36D2298359

Facility Name: INDEPENDENT DIALYSIS GROUP NORTHEAST OHIO

Facility Address:
9184 MARKET STREET
NORTH LIMA, OH
ZIP 44452
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Facility Phone Number: 330 781-6212

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1518570886

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2298359
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	INDEPENDENT DIALYSIS GROUP NORTHEAST OHIO
Street	9184 MARKET STREET
City	NORTH LIMA
State	OH
ZIP	44452
Phone	330 781-6212
CertificateType	4
CertificateEffectiveDate	2/1/2024
CertificateExpirationDate	1/31/2026
FacilityType	Waiver

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