05D0663602 CLIA NUMBER - GAREY DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 05D0663602

Facility Name: GAREY DIALYSIS CENTER

Facility Address:
150 EAST ARROW HIGHWAY
POMONA, CA
ZIP 91767
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Facility Phone Number: 909 593-5863

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1689748790

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0663602
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	GAREY DIALYSIS CENTER
Street	150 EAST ARROW HIGHWAY
City	POMONA
State	CA
ZIP	91767
Phone	909 593-5863
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