05D1006218 CLIA NUMBER - IOWA STREET DIALYSIS

Laboratory Demographics

CLIA Number: 05D1006218

Facility Name: IOWA STREET DIALYSIS

Facility Address:
8333 IOWA ST STE 100
DOWNEY, CA
ZIP 90241
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Facility Phone Number: 562 923-5901

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1962754333

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1006218
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	IOWA STREET DIALYSIS
Street	8333 IOWA ST STE 100
City	DOWNEY
State	CA
ZIP	90241
Phone	562 923-5901
CertificateType	4
CertificateEffectiveDate	11/12/2022
CertificateExpirationDate	11/11/2024
FacilityType	Waiver

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