05D0663604 CLIA NUMBER - GREATER EL MONTE DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 05D0663604
  • Facility Name: GREATER EL MONTE DIALYSIS CENTER
  • Facility Address: 1938 TYLER AVENUE, SUITE J-168
    SOUTH EL MONTE, CA
    ZIP 91733
  • Facility Phone: 626 350-6692
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CARLOS GONZALEZ MD
  • NPI Number: 1457310807
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0663604
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GREATER EL MONTE DIALYSIS CENTER
Street 1938 TYLER AVENUE, SUITE J-168
City SOUTH EL MONTE
State CA
ZIP 91733
Phone 626 350-6692
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CARLOS GONZALEZ MD

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This page was last updated on: 9/29/2025