39D1056617 CLIA NUMBER - LIBERTY DIALYSIS-WASHINGTON

Laboratory Demographics

CLIA Number: 39D1056617

Facility Name: LIBERTY DIALYSIS-WASHINGTON

Facility Address:
90 W CHESTNUT ST, 100 EW
WASHINGTON, PA
ZIP 15301
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Facility Phone Number: 724 228-7398

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1144262692

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D1056617
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LIBERTY DIALYSIS-WASHINGTON
Street	90 W CHESTNUT ST, 100 EW
City	WASHINGTON
State	PA
ZIP	15301
Phone	724 228-7398
CertificateType	4
CertificateEffectiveDate	7/20/2022
CertificateExpirationDate	7/19/2024
FacilityType	Waiver

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