05D1011116 CLIA NUMBER - WHITE LANE DIALYSIS

Laboratory Demographics

CLIA Number: 05D1011116

Facility Name: WHITE LANE DIALYSIS

Facility Address:
7701 WHITE LANE SUITE D
BAKERSFIELD, CA
ZIP 93309
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Facility Phone Number: 661 396-7158

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1033183397

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1011116
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	WHITE LANE DIALYSIS
Street	7701 WHITE LANE SUITE D
City	BAKERSFIELD
State	CA
ZIP	93309
Phone	661 396-7158
CertificateType	4
CertificateEffectiveDate	4/1/2023
CertificateExpirationDate	3/31/2025
FacilityType	Waiver

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