05D1006677 CLIA NUMBER - COLLEGE DIALYSIS

Laboratory Demographics

CLIA Number: 05D1006677

Facility Name: COLLEGE DIALYSIS

Facility Address:
6035 UNIVERSITY AVE
SAN DIEGO, CA
ZIP 92115
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Facility Phone Number: 619 287-8796

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1902870330

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1006677
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	COLLEGE DIALYSIS
Street	6035 UNIVERSITY AVE
City	SAN DIEGO
State	CA
ZIP	92115
Phone	619 287-8796
CertificateType	4
CertificateEffectiveDate	11/26/2022
CertificateExpirationDate	11/25/2024
FacilityType	Waiver

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