05D0877116 CLIA NUMBER - LA PALMA DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 05D0877116
  • Facility Name: LA PALMA DIALYSIS CENTER
  • Facility Address: 7880 VALLEY VIEW ST
    BUENA PARK, CA
    ZIP 90620
  • Facility Phone: 714 670-6812
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ASHA RAVIKUMAR
  • NPI Number: 1508118977
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0877116
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LA PALMA DIALYSIS CENTER
Street 7880 VALLEY VIEW ST
City BUENA PARK
State CA
ZIP 90620
Phone 714 670-6812
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2025
Certificate Expiration Date 9/28/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ASHA RAVIKUMAR

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