05D0952591 CLIA NUMBER - LOMPOC ARTIFICIAL KIDNEY CENTER, LLC

Laboratory Demographics

CLIA Number: 05D0952591

Facility Name: LOMPOC ARTIFICIAL KIDNEY CENTER, LLC

Facility Address:
127 WEST PINE
LOMPOC, CA
ZIP 93436
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Facility Phone Number: 805 740-2000

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1770618571

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0952591
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LOMPOC ARTIFICIAL KIDNEY CENTER, LLC
Street	127 WEST PINE
City	LOMPOC
State	CA
ZIP	93436
Phone	805 740-2000
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

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