05D1072417 CLIA NUMBER - WEST SACRAMENTO DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 05D1072417
  • Facility Name: WEST SACRAMENTO DIALYSIS CENTER
  • Facility Address: 3450 INDUSTRIAL BLVD STE 100
    WEST SACRAMENTO, CA
    ZIP 95691
  • Facility Phone: 916 371-4947
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RATNAJI B. NALLAMOTHU
  • NPI Number: 1598896250
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1072417
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WEST SACRAMENTO DIALYSIS CENTER
Street 3450 INDUSTRIAL BLVD STE 100
City WEST SACRAMENTO
State CA
ZIP 95691
Phone 916 371-4947
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RATNAJI B. NALLAMOTHU

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This page was last updated on: 9/29/2025