45D0926200 CLIA NUMBER - CENTRAL HOUSTON DIALYSIS

Laboratory Demographics

CLIA Number: 45D0926200

Facility Name: CENTRAL HOUSTON DIALYSIS

Facility Address:
610 SOUTH WAYSIDE, SUITE B
HOUSTON, TX
ZIP 77011
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Facility Phone Number: 713 928-8188

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1770546848

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D0926200
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CENTRAL HOUSTON DIALYSIS
Street	610 SOUTH WAYSIDE, SUITE B
City	HOUSTON
State	TX
ZIP	77011
Phone	713 928-8188
CertificateType	4
CertificateEffectiveDate	3/18/2023
CertificateExpirationDate	3/17/2025
FacilityType	Waiver

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