05D0941861 CLIA NUMBER - LOS BANOS DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D0941861
  • Facility Name: LOS BANOS DIALYSIS
  • Facility Address: 60 G ST, BLDG 5
    LOS BANOS, CA
    ZIP 93635
  • Facility Phone: 209 826-7280
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DANIEL IKEMIYASHIRO MD
  • NPI Number: 1851952113
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0941861
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LOS BANOS DIALYSIS
Street 60 G ST, BLDG 5
City LOS BANOS
State CA
ZIP 93635
Phone 209 826-7280
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DANIEL IKEMIYASHIRO MD

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