Massapequa Dialysis
Director
							Eduard Bover, D.O.
			Expiration Date
							Phone Number
							(516) 927-7192
			UID (Facility ID - Site ID)
							F117-0000
			Site ID
							0000
			City
							Massapequa
			CLIA Number
							33D2258349
			Street Address
							1071 N Broadway
			State
							NY
			Zip Code
							11758-1802
			County
							Nassau
			Country
							United States
			Fax Number
							(516) 927-7665
			Primary Contact
							Carrie Pence
			Contact Phone Number
							(615) 341-6410
			Certificate Type
							WAIVER
			Tests
				Glucose
					Facility ID
							F117