49D2110843 CLIA NUMBER - LABURNUM DIALYSIS

Laboratory Demographics

CLIA Number: 49D2110843

Facility Name: LABURNUM DIALYSIS

Facility Address:
4352 S LABURNUM AVENUE
RICHMOND, VA
ZIP 23231
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Facility Phone Number: 804 236-4699

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1598123655

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D2110843
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LABURNUM DIALYSIS
Street	4352 S LABURNUM AVENUE
City	RICHMOND
State	VA
ZIP	23231
Phone	804 236-4699
CertificateType	4
CertificateEffectiveDate	3/24/2024
CertificateExpirationDate	3/23/2026
FacilityType	Waiver

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