05D0856279 CLIA NUMBER - HIGH DESERT HEMODIALYSIS

Laboratory Demographics

CLIA Number: 05D0856279

Facility Name: HIGH DESERT HEMODIALYSIS

Facility Address:
1007 W AVE M-14 STE B
PALMDALE, CA
ZIP 93551
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Facility Phone Number: 661 265-7810

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1811917362

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0856279
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HIGH DESERT HEMODIALYSIS
Street	1007 W AVE M-14 STE B
City	PALMDALE
State	CA
ZIP	93551
Phone	661 265-7810
CertificateType	4
CertificateEffectiveDate	4/1/2024
CertificateExpirationDate	3/31/2026
FacilityType	Waiver

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