05D0881139 CLIA NUMBER - RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC

Laboratory Demographics

CLIA Number: 05D0881139

Facility Name: RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC

Facility Address:
610 HEGENBERGER ROAD, SUITE 101A
OAKLAND, CA
ZIP 94621
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Facility Phone Number: 510 430-8311

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1336213594

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0881139
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RAI CARE CENTERS OF NORTHERN CALIFORNIA II, LLC
Street	610 HEGENBERGER ROAD, SUITE 101A
City	OAKLAND
State	CA
ZIP	94621
Phone	510 430-8311
CertificateType	4
CertificateEffectiveDate	2/6/2023
CertificateExpirationDate	2/5/2025
FacilityType	Waiver

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