05D0940182 CLIA NUMBER - USRC PACIFIC GATEWAY, LLC DBA U.S. RENAL CARE PACIFIC GATEWAY DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D0940182
  • Facility Name: USRC PACIFIC GATEWAY, LLC DBA U.S. RENAL CARE PACIFIC GATEWAY DIALYSIS
  • Facility Address: 1149 W 190TH ST STE 1004
    GARDENA, CA
    ZIP 90248
  • Facility Phone: 310 965-0830
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: EDGAR MUSNGI
  • NPI Number: 1962903690
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0940182
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name USRC PACIFIC GATEWAY, LLC DBA U.S. RENAL CARE PACIFIC GATEWAY DIALYSIS
Street 1149 W 190TH ST STE 1004
City GARDENA
State CA
ZIP 90248
Phone 310 965-0830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director EDGAR MUSNGI

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