45D0659526 CLIA NUMBER - FRESENIUS MEDICAL CARE ENNIS-CLIA LABORATORY

Laboratory Demographics

CLIA Number: 45D0659526

Facility Name: FRESENIUS MEDICAL CARE ENNIS-CLIA LABORATORY

Facility Address:
711 SOUTH CLAY STREET, SUITE B
ENNIS, TX
ZIP 75119
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Facility Phone Number: 972 875-8469

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1679685556

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D0659526
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE ENNIS-CLIA LABORATORY
Street	711 SOUTH CLAY STREET, SUITE B
City	ENNIS
State	TX
ZIP	75119
Phone	972 875-8469
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