05D0928535 CLIA NUMBER - SANTA PAULA DIALYSIS

Laboratory Demographics

CLIA Number: 05D0928535

Facility Name: SANTA PAULA DIALYSIS

Facility Address:
253 MARCH STREET
SANTA PAULA, CA
ZIP 93060
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Facility Phone Number: 805 525-3977

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1548599251

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0928535
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SANTA PAULA DIALYSIS
Street	253 MARCH STREET
City	SANTA PAULA
State	CA
ZIP	93060
Phone	805 525-3977
CertificateType	4
CertificateEffectiveDate	5/20/2023
CertificateExpirationDate	5/19/2025
FacilityType	Waiver

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