49D0661156 CLIA NUMBER - BMA-FMC WEST END DIALYSIS

Laboratory Demographics

CLIA Number: 49D0661156

Facility Name: BMA-FMC WEST END DIALYSIS

Facility Address:
1501 SANTA ROSA ROAD
RICHMOND, VA
ZIP 23229
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Facility Phone Number: 804 288-5053

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1467556233

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D0661156
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BMA-FMC WEST END DIALYSIS
Street	1501 SANTA ROSA ROAD
City	RICHMOND
State	VA
ZIP	23229
Phone	804 288-5053
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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