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: 1/7/2022