05D1000614 CLIA NUMBER - VISALIA DIALYSIS

Laboratory Demographics

CLIA Number: 05D1000614

Facility Name: VISALIA DIALYSIS

Facility Address:
5429 W CYPRESS
VISALIA, CA
ZIP 93277
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Facility Phone Number: 559 738-9279

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1487629382

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1000614
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	VISALIA DIALYSIS
Street	5429 W CYPRESS
City	VISALIA
State	CA
ZIP	93277
Phone	559 738-9279
CertificateType	4
CertificateEffectiveDate	6/18/2022
CertificateExpirationDate	6/17/2024
FacilityType	Waiver

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