44D0315531 CLIA NUMBER - DIALYSIS CLINIC INC

Laboratory Demographics

CLIA Number: 44D0315531

Facility Name: DIALYSIS CLINIC INC

Facility Address:
93 RIDGECREST ROAD
JACKSON, TN
ZIP 38305
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Facility Phone Number: 901 668-0800

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1306874953

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D0315531
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS CLINIC INC
Street	93 RIDGECREST ROAD
City	JACKSON
State	TN
ZIP	38305
Phone	901 668-0800
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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