05D0587935 CLIA NUMBER - ANTELOPE VALLEY DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 05D0587935

Facility Name: ANTELOPE VALLEY DIALYSIS CENTER

Facility Address:
1759 WEST AVENUE J # 102
LANCASTER, CA
ZIP 93534
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Facility Phone Number: (661) 942-6400

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1083898001

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0587935
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	ANTELOPE VALLEY DIALYSIS CENTER
Street	1759 WEST AVENUE J # 102
City	LANCASTER
State	CA
ZIP	93534
Phone	(661) 942-6400

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