05D1088405 CLIA NUMBER - MONTEBELLO ARTIFICIAL KIDNEY CENTER

Laboratory Demographics

  • CLIA Code: 05D1088405
  • Facility Name: MONTEBELLO ARTIFICIAL KIDNEY CENTER
  • Facility Address: 3404 W BEVERLY BLVD
    MONTEBELLO, CA
    ZIP 90640
  • Facility Phone: 323 728-7580
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: EDGAR P. TOSCANO
  • NPI Number: 1790960060
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1088405
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MONTEBELLO ARTIFICIAL KIDNEY CENTER
Street 3404 W BEVERLY BLVD
City MONTEBELLO
State CA
ZIP 90640
Phone 323 728-7580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director EDGAR P. TOSCANO

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