05D0573366 CLIA NUMBER - FONTANA DIALYSIS

Laboratory Demographics

CLIA Number: 05D0573366

Facility Name: FONTANA DIALYSIS

Facility Address:
17590 FOOTHILL BOULEVARD
FONTANA, CA
ZIP 92335
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Facility Phone Number: (909) 356-9664

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1326012311

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 05D0573366
LAB Type END STAGE RENAL DISEASE DIALYSIS
Facility Name FONTANA DIALYSIS
Street 17590 FOOTHILL BOULEVARD
City FONTANA
State CA
ZIP 92335
Phone (909) 356-9664

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This page was last updated on: 1/7/2022