45D2024977 CLIA NUMBER - SPRING CREEK DIALYSIS

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Laboratory Demographics

CLIA Number: 45D2024977

Facility Name: SPRING CREEK DIALYSIS

Facility Address:
301 E AIRLINE ROAD
VICTORIA, TX
ZIP 77901
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Facility Phone Number: 361 572-3343

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1326345901

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2024977
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SPRING CREEK DIALYSIS
Street	301 E AIRLINE ROAD
City	VICTORIA
State	TX
ZIP	77901
Phone	361 572-3343
CertificateType	4
CertificateEffectiveDate	5/27/2023
CertificateExpirationDate	5/26/2025
FacilityType	Waiver

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