05D0921250 CLIA NUMBER - FRESENIUS MEDICAL CARE BALBOA EAST COUNTY

Laboratory Demographics

CLIA Number: 05D0921250

Facility Name: FRESENIUS MEDICAL CARE BALBOA EAST COUNTY

Facility Address:
570 NORTH SECOND STREET
EL CAJON, CA
ZIP 92021
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Facility Phone Number: 619 588-7500

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1962839183

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0921250
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE BALBOA EAST COUNTY
Street	570 NORTH SECOND STREET
City	EL CAJON
State	CA
ZIP	92021
Phone	619 588-7500
CertificateType	4
CertificateEffectiveDate	10/22/2022
CertificateExpirationDate	10/21/2024
FacilityType	Waiver

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