40D2144992 CLIA NUMBER - BIO MEDICAL APPLICATION OF PUERTO RICO D/B/A FRESENIUS KIDNEY

Laboratory Demographics

CLIA Number: 40D2144992

Facility Name: BIO MEDICAL APPLICATION OF PUERTO RICO D/B/A FRESENIUS KIDNEY

Facility Address:
CARR 726 KM O, HM 7, CAONILLAS WARD
AIBONITO, PR
ZIP 00705
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Facility Phone Number: 939 250-9683

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1730637042

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	40D2144992
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BIO MEDICAL APPLICATION OF PUERTO RICO D/B/A FRESENIUS KIDNEY
Street	CARR 726 KM O, HM 7, CAONILLAS WARD
City	AIBONITO
State	PR
ZIP	00705
Phone	939 250-9683
CertificateType	4
CertificateEffectiveDate	2/27/2024
CertificateExpirationDate	2/26/2026
FacilityType	Waiver

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