45D1076023 CLIA NUMBER - USRC MISSION LP DBA US RENAL CARE MISSION DIALYSIS

Laboratory Demographics

CLIA Number: 45D1076023

Facility Name: USRC MISSION LP DBA US RENAL CARE MISSION DIALYSIS

Facility Address:
1200 SAINT CLAIRE BLVD
MISSION, TX
ZIP 78572
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Facility Phone Number: 956 581-8489

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1639156193

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D1076023
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	USRC MISSION LP DBA US RENAL CARE MISSION DIALYSIS
Street	1200 SAINT CLAIRE BLVD
City	MISSION
State	TX
ZIP	78572
Phone	956 581-8489
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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