05D0928538 CLIA NUMBER - SIMI VALLEY DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D0928538
  • Facility Name: SIMI VALLEY DIALYSIS
  • Facility Address: 970 ENCHANTED WAY
    SIMI VALLEY, CA
    ZIP 93065
  • Facility Phone: 805 584-9621
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JIESHI YAN
  • NPI Number: 1467781179
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0928538
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SIMI VALLEY DIALYSIS
Street 970 ENCHANTED WAY
City SIMI VALLEY
State CA
ZIP 93065
Phone 805 584-9621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JIESHI YAN

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