45D2181781 CLIA NUMBER - ANGELO KIDNEY CONNECTION HOME THERAPIES, PLLC

Laboratory Demographics

CLIA Number: 45D2181781

Facility Name: ANGELO KIDNEY CONNECTION HOME THERAPIES, PLLC

Facility Address:
3626 50TH STREET
LUBBOCK, TX
ZIP 79413
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Facility Phone Number: 325 450-4445

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1598310179

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2181781
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ANGELO KIDNEY CONNECTION HOME THERAPIES, PLLC
Street	3626 50TH STREET
City	LUBBOCK
State	TX
ZIP	79413
Phone	325 450-4445
CertificateType	4
CertificateEffectiveDate	4/10/2024
CertificateExpirationDate	4/9/2026
FacilityType	Waiver

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