50D0995555 CLIA NUMBER - OMAK DIALYSIS UNIT

Laboratory Demographics

CLIA Number: 50D0995555

Facility Name: OMAK DIALYSIS UNIT

Facility Address:
800 JASMINE ST SUITE 1
OMAK, WA
ZIP 98841
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Facility Phone Number: 509 826-8680

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1154433050

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D0995555
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	OMAK DIALYSIS UNIT
Street	800 JASMINE ST SUITE 1
City	OMAK
State	WA
ZIP	98841
Phone	509 826-8680
CertificateType	4
CertificateEffectiveDate	1/23/2002
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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