44D1095398 CLIA NUMBER - CAPELVILLE DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 44D1095398

Facility Name: CAPELVILLE DIALYSIS CENTER

Facility Address:
7008 EAST SHELBY DRIVE
MEMPHIS, TN
ZIP 38125
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Facility Phone Number: 615 341-6793

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1255578837

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D1095398
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CAPELVILLE DIALYSIS CENTER
Street	7008 EAST SHELBY DRIVE
City	MEMPHIS
State	TN
ZIP	38125
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