05D0694246 CLIA NUMBER - ESCONDIDO DIALYSIS

Laboratory Demographics

CLIA Number: 05D0694246

Facility Name: ESCONDIDO DIALYSIS

Facility Address:
203 E 2ND AVE
ESCONDIDO, CA
ZIP 92025
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Facility Phone Number: 760 743-4401

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1902870298

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0694246
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ESCONDIDO DIALYSIS
Street	203 E 2ND AVE
City	ESCONDIDO
State	CA
ZIP	92025
Phone	760 743-4401
CertificateType	4
CertificateEffectiveDate	8/20/2023
CertificateExpirationDate	8/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024