44D2015478 CLIA NUMBER - ISD BARTLETT LLC DBA BARTLETT RENAL CENTER

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Laboratory Demographics

CLIA Number: 44D2015478

Facility Name: ISD BARTLETT LLC DBA BARTLETT RENAL CENTER

Facility Address:
2920 COVINGTON PIKE
MEMPHIS, TN
ZIP 38128
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Facility Phone Number: 901 248-6020

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1407161730

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2015478
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ISD BARTLETT LLC DBA BARTLETT RENAL CENTER
Street	2920 COVINGTON PIKE
City	MEMPHIS
State	TN
ZIP	38128
Phone	901 248-6020
CertificateType	4
CertificateEffectiveDate	10/28/2022
CertificateExpirationDate	10/27/2024
FacilityType	Waiver

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