05D0573365 CLIA NUMBER - POMONA DIALYSIS

Laboratory Demographics

CLIA Number: 05D0573365

Facility Name: POMONA DIALYSIS

Facility Address:
2111 N GAREY AVE
POMONA, CA
ZIP 91767
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Facility Phone Number: (909) 596-9997

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1609840347

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0573365
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	POMONA DIALYSIS
Street	2111 N GAREY AVE
City	POMONA
State	CA
ZIP	91767
Phone	(909) 596-9997

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This page was last updated on: 5/11/2023