05D0994480 CLIA NUMBER - FMC DIALYSIS SERVICES -SAN BERNARDINO

Laboratory Demographics

CLIA Number: 05D0994480

Facility Name: FMC DIALYSIS SERVICES -SAN BERNARDINO

Facility Address:
636 EAST BRIER DRIVE SUITE 150
SAN BERNARDINO, CA
ZIP 92408
Get Directions

Facility Phone Number: 909 890-9508

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1700998507

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0994480
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FMC DIALYSIS SERVICES -SAN BERNARDINO
Street	636 EAST BRIER DRIVE SUITE 150
City	SAN BERNARDINO
State	CA
ZIP	92408
Phone	909 890-9508
CertificateType	4
CertificateEffectiveDate	12/14/2023
CertificateExpirationDate	12/13/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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