39D2089281 CLIA NUMBER - TYRONE DIALYSIS

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Laboratory Demographics

CLIA Number: 39D2089281

Facility Name: TYRONE DIALYSIS

Facility Address:
175 HOSPITAL DRIVE
TYRONE, PA
ZIP 16686
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Facility Phone Number: 814 684-4390

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1073912721

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2089281
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	TYRONE DIALYSIS
Street	175 HOSPITAL DRIVE
City	TYRONE
State	PA
ZIP	16686
Phone	814 684-4390
CertificateType	4
CertificateEffectiveDate	12/24/2022
CertificateExpirationDate	12/23/2024
FacilityType	Waiver

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