39D1062497 CLIA NUMBER - CENTRAL KITTANNING DIALYSIS CENTER LLC

Laboratory Demographics

CLIA Number: 39D1062497

Facility Name: CENTRAL KITTANNING DIALYSIS CENTER LLC

Facility Address:
ONE NOLTE DRIVE MEDICAL ARTS BUILDING, SUITE 720
KITTANNING, PA
ZIP 16201
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Facility Phone Number: 724 543-3151

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1114085990

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D1062497
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CENTRAL KITTANNING DIALYSIS CENTER LLC
Street	ONE NOLTE DRIVE MEDICAL ARTS BUILDING, SUITE 720
City	KITTANNING
State	PA
ZIP	16201
Phone	724 543-3151
CertificateType	4
CertificateEffectiveDate	12/15/2022
CertificateExpirationDate	12/14/2024
FacilityType	Waiver

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