05D0570407 CLIA NUMBER - SAN DIEGO DIALYSIS SERVICES INC

Laboratory Demographics

CLIA Number: 05D0570407

Facility Name: SAN DIEGO DIALYSIS SERVICES INC

Facility Address:
303 WEST 26TH STREET
NATIONAL CITY, CA
ZIP 91950
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Facility Phone Number: 619 474-8151

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1659483451

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0570407
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SAN DIEGO DIALYSIS SERVICES INC
Street	303 WEST 26TH STREET
City	NATIONAL CITY
State	CA
ZIP	91950
Phone	619 474-8151
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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