05D0718174 CLIA NUMBER - RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC (RAI-TELEGRAPH-PERALTA)

Laboratory Demographics

CLIA Number: 05D0718174

Facility Name: RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC (RAI-TELEGRAPH-PERALTA)

Facility Address:
2757 TELEGRAPH AVENUE
OAKLAND, CA
ZIP 94612
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Facility Phone Number: 510 835-0154

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1003980350

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0718174
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC (RAI-TELEGRAPH-PERALTA)
Street	2757 TELEGRAPH AVENUE
City	OAKLAND
State	CA
ZIP	94612
Phone	510 835-0154
CertificateType	4
CertificateEffectiveDate	12/20/2023
CertificateExpirationDate	12/19/2025
FacilityType	Waiver

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