44D1095394 CLIA NUMBER - MILLINGTON DIALYSIS

Laboratory Demographics

CLIA Number: 44D1095394

Facility Name: MILLINGTON DIALYSIS

Facility Address:
8510 WILKINSVILLE ROAD STE 121
MILLINGTON, TN
ZIP 38053
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Facility Phone Number: 615 341-6793

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1457590192

Taxonomy: 2080N0001X - Pediatrics
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

CLIA Record

Field Name	Field Value
CLIA Number	44D1095394
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	MILLINGTON DIALYSIS
Street	8510 WILKINSVILLE ROAD STE 121
City	MILLINGTON
State	TN
ZIP	38053
Phone	615 341-6793
CertificateType	4
CertificateEffectiveDate	2/6/2023
CertificateExpirationDate	2/5/2025
FacilityType	Waiver

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