45D0982057 CLIA NUMBER - NATIONAL NEPHROLOGY ASSOCIATES OF TX LP BASTROP

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Laboratory Demographics

CLIA Number: 45D0982057

Facility Name: NATIONAL NEPHROLOGY ASSOCIATES OF TX LP BASTROP

Facility Address:
423 OLD AUSTIN HIGHWAY
BASTROP, TX
ZIP 78602
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Facility Phone Number: 512 581-9993

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1881706760

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D0982057
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NATIONAL NEPHROLOGY ASSOCIATES OF TX LP BASTROP
Street	423 OLD AUSTIN HIGHWAY
City	BASTROP
State	TX
ZIP	78602
Phone	512 581-9993
CertificateType	4
CertificateEffectiveDate	1/16/2023
CertificateExpirationDate	1/15/2025
FacilityType	Waiver

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