05D0977472 CLIA NUMBER - QUEENS DIALYSIS UNIT INC

Laboratory Demographics

  • CLIA Code: 05D0977472
  • Facility Name: QUEENS DIALYSIS UNIT INC
  • Facility Address: 1135 S SUNSET AVE STE 103
    WEST COVINA, CA
    ZIP 91790
  • Facility Phone: 626 337-4245
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CLAUDIO H. GALLEGO MD
  • NPI Number: 1710998380
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0977472
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name QUEENS DIALYSIS UNIT INC
Street 1135 S SUNSET AVE STE 103
City WEST COVINA
State CA
ZIP 91790
Phone 626 337-4245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CLAUDIO H. GALLEGO MD

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