Organization
TOTAL RENAL LABORATORIES INC
Active
Parent organization
TOTAL RENAL CARE INC
Other names
DaVita Labs
Organization subpart
Yes
Provider details
NPI number
Legal business name
TOTAL RENAL CARE INC
Authorized official
KERI WAGNER (VP - GENERAL MANAGER)
(386) 626-5700
Entity
Organization
Contact information
Practice address
3000 DAVITA WAY, DELAND, FL 32724
(386) 626-5700
(386) 626-5638
Mailing address
PO BOX 100244, ATLANTA, GA 30384-0244
(386) 626-5700
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800005025
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015880660004
—
PA
05
—
003214508A
—
GA
05
—
02244535
—
NY
05
—
0326359
—
OH
05
—
0412083
—
IA
05
—
04402709
—
MS
05
—
0706493
—
NJ
05
—
081833728
—
DC
05
—
10026760900
—
NE
05
—
100758080B
—
OK
05
—
101245100
—
FL
05
—
110148599A
—
MA
05
—
1245720820
—
CA
05
—
1245720820
—
CO
05
—
1245720820
—
CT
05
—
1245720820
—
ID
05
—
1245720820
—
ME
05
—
1245720820
—
MI
05
—
1245720820
—
MN
05
—
1245720820
—
MT
05
—
1245720820
—
NC
05
—
1245720820
—
SD
05
—
1245720820
—
VA
05
—
1245720820
—
WI
05
—
1245720820
—
WV
05
—
1245720820
—
WY
05
—
1477612
—
ND
05
—
2124491
—
WA
05
—
228520
—
AL
05
—
232372709
—
AR
05
—
2488171
—
LA
05
—
283981402
—
MD
05
—
300022760
—
IN
05
—
30003947130002
—
KS
05
—
3010008
—
UT
05
—
3118922
—
NH
05
—
38436361
—
NM
05
—
3995045-01
—
TX
05
—
500761736
—
OR
05
—
504222
—
AZ
05
—
700066284
—
MO
05
—
7100581410
—
KY
05
—
L00677
—
SC
05
—
Q069472
—
TN
Enumeration date
05/18/2018
Last updated
08/28/2024
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