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37D2121599 CLIA NUMBER - PAULS VALLEY DIALYSIS TOTAL RENAL CARE INC

Laboratory Demographics

CLIA Number: 37D2121599

Facility Name: PAULS VALLEY DIALYSIS TOTAL RENAL CARE INC

Facility Address:
2410 W GRANT AVE
PAULS VALLEY, OK
ZIP 73075
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Facility Phone Number: 405 207-9274

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver
NPI Number: 1932169950

Taxonomy: 282N00000X - General Acute Care Hospital
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

CLIA Record

Field Name Field Value
CLIA Number 37D2121599
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PAULS VALLEY DIALYSIS TOTAL RENAL CARE INC
Street 2410 W GRANT AVE
City PAULS VALLEY
State OK
ZIP 73075
Phone 405 207-9274
CertificateType 4
CertificateEffectiveDate 11/8/2022
CertificateExpirationDate 11/7/2024
FacilityType Waiver

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