50D2063067 CLIA NUMBER - ZILLAH DIALYSIS

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Laboratory Demographics

CLIA Number: 50D2063067

Facility Name: ZILLAH DIALYSIS

Facility Address:
823 ZILLAH WEST RD STE 300
ZILLAH, WA
ZIP 98953
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Facility Phone Number: 509 829-0209

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1659718781

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2063067
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ZILLAH DIALYSIS
Street	823 ZILLAH WEST RD STE 300
City	ZILLAH
State	WA
ZIP	98953
Phone	509 829-0209
CertificateType	4
CertificateEffectiveDate	7/25/2013
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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