05D1088753 CLIA NUMBER - NEWPORT-MESA DIALYSIS SERVICES

Laboratory Demographics

CLIA Number: 05D1088753

Facility Name: NEWPORT-MESA DIALYSIS SERVICES

Facility Address:
1175 BAKER STREET SUITE B
COSTA MESA, CA
ZIP 92626
Get Directions

Facility Phone Number: 714 641-5808

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1730337536

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1088753
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	NEWPORT-MESA DIALYSIS SERVICES
Street	1175 BAKER STREET SUITE B
City	COSTA MESA
State	CA
ZIP	92626
Phone	714 641-5808
CertificateType	4
CertificateEffectiveDate	9/3/2022
CertificateExpirationDate	9/2/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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