37D2166630 CLIA NUMBER - FRESENIUS KIDNEY CARE CLAREMORE

Laboratory Demographics

CLIA Number: 37D2166630

Facility Name: FRESENIUS KIDNEY CARE CLAREMORE

Facility Address:
215 S BRADY ST ATTN ANGELA HANSHAW
CLAREMORE, OK
ZIP 74017
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Facility Phone Number: 318 342-2174

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1487206595

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D2166630
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE CLAREMORE
Street	215 S BRADY ST ATTN ANGELA HANSHAW
City	CLAREMORE
State	OK
ZIP	74017
Phone	318 342-2174
CertificateType	4
CertificateEffectiveDate	5/21/2023
CertificateExpirationDate	5/20/2025
FacilityType	Waiver

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