39D0939821 CLIA NUMBER - THORN RUN DIALYSIS

Laboratory Demographics

CLIA Number: 39D0939821

Facility Name: THORN RUN DIALYSIS

Facility Address:
1136 THORN RUN ROAD SUITE J1
MOON TOWNSHIP, PA
ZIP 15108
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Facility Phone Number: 412 269-2304

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1114153665

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D0939821
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	THORN RUN DIALYSIS
Street	1136 THORN RUN ROAD SUITE J1
City	MOON TOWNSHIP
State	PA
ZIP	15108
Phone	412 269-2304
CertificateType	4
CertificateEffectiveDate	2/2/2024
CertificateExpirationDate	2/1/2026
FacilityType	Waiver

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