39D2206442 CLIA NUMBER - FRESENIUS KIDNEY CARE BACK MOUNTAIN

Laboratory Demographics

  • CLIA Code: 39D2206442
  • Facility Name: FRESENIUS KIDNEY CARE BACK MOUNTAIN
  • Facility Address: 130 CROSSFIELD DR
    DALLAS, PA
    ZIP 18612
  • Facility Phone: 570 262-0922
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. JEANNE L. DREIER
  • NPI Number: 1306430137
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D2206442
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FRESENIUS KIDNEY CARE BACK MOUNTAIN
Street 130 CROSSFIELD DR
City DALLAS
State PA
ZIP 18612
Phone 570 262-0922
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. JEANNE L. DREIER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025