05D0643109 CLIA NUMBER - FRESENIUS MEDICAL CARE BALBOA, LLC DBA FRESENIUS MEDICAL CARE BALBOA-KEARNY MESA

Laboratory Demographics

CLIA Number: 05D0643109

Facility Name: FRESENIUS MEDICAL CARE BALBOA, LLC DBA FRESENIUS MEDICAL CARE BALBOA-KEARNY MESA

Facility Address:
7927 OSTROW STREET, SUITE A
SAN DIEGO, CA
ZIP 92111
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Facility Phone Number: 858 571-0232

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1376784389

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0643109
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE BALBOA, LLC DBA FRESENIUS MEDICAL CARE BALBOA-KEARNY MESA
Street	7927 OSTROW STREET, SUITE A
City	SAN DIEGO
State	CA
ZIP	92111
Phone	858 571-0232
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