45D2034667 CLIA NUMBER - VILLAGE DIALYSIS

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Laboratory Demographics

CLIA Number: 45D2034667

Facility Name: VILLAGE DIALYSIS

Facility Address:
6952 INDUSTRIAL PKWY
ROSENBERG, TX
ZIP 77471
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Facility Phone Number: 281 232-3116

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1760767370

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2034667
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	VILLAGE DIALYSIS
Street	6952 INDUSTRIAL PKWY
City	ROSENBERG
State	TX
ZIP	77471
Phone	281 232-3116
CertificateType	4
CertificateEffectiveDate	12/30/2023
CertificateExpirationDate	12/29/2025
FacilityType	Waiver

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