45D2081983 CLIA NUMBER - CLOVERLEAF DIALYSIS

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Laboratory Demographics

CLIA Number: 45D2081983

Facility Name: CLOVERLEAF DIALYSIS

Facility Address:
13525 EAST FWY STE A
HOUSTON, TX
ZIP 77015
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Facility Phone Number: 713 450-0874

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1407260789

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2081983
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CLOVERLEAF DIALYSIS
Street	13525 EAST FWY STE A
City	HOUSTON
State	TX
ZIP	77015
Phone	713 450-0874
CertificateType	4
CertificateEffectiveDate	8/5/2022
CertificateExpirationDate	8/4/2024
FacilityType	Waiver

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