05D0924350 CLIA NUMBER - MONTCLAIR DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 05D0924350

Facility Name: MONTCLAIR DIALYSIS CENTER

Facility Address:
9142 MONTE VISTA AVENUE
MONTCLAIR, CA
ZIP 91763
Get Directions

Facility Phone Number: 909 626-6505

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1992768329

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0924350
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	MONTCLAIR DIALYSIS CENTER
Street	9142 MONTE VISTA AVENUE
City	MONTCLAIR
State	CA
ZIP	91763
Phone	909 626-6505
CertificateType	4
CertificateEffectiveDate	1/28/2023
CertificateExpirationDate	1/27/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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