38D0982662 CLIA NUMBER - LINCOLN CITY DIALYSIS

Laboratory Demographics

CLIA Number: 38D0982662

Facility Name: LINCOLN CITY DIALYSIS

Facility Address:
2817 NE WEST DEVILS LAKE RD
LINCOLN CITY, OR
ZIP 97367
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Facility Phone Number: 541 996-2008

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1841787934

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D0982662
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LINCOLN CITY DIALYSIS
Street	2817 NE WEST DEVILS LAKE RD
City	LINCOLN CITY
State	OR
ZIP	97367
Phone	541 996-2008
CertificateType	4
CertificateEffectiveDate	5/24/2022
CertificateExpirationDate	5/23/2024
FacilityType	Waiver

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