05D1059197 CLIA NUMBER - NATOMAS DIALYSIS

Laboratory Demographics

CLIA Number: 05D1059197

Facility Name: NATOMAS DIALYSIS

Facility Address:
30 GOLDENLAND COURT, BLDG G
SACRAMENTO, CA
ZIP 95834
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Facility Phone Number: 916 285-6452

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1154348068

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1059197
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NATOMAS DIALYSIS
Street	30 GOLDENLAND COURT, BLDG G
City	SACRAMENTO
State	CA
ZIP	95834
Phone	916 285-6452
CertificateType	4
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Waiver

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