05D1093772 CLIA NUMBER - YOSEMITE STREET DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 05D1093772
  • Facility Name: YOSEMITE STREET DIALYSIS CENTER
  • Facility Address: 1650 WEST YOSEMITE AVENUE
    MANTECA, CA
    ZIP 95337
  • Facility Phone: 209 824-5552
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MEHUL RAVAL MD
  • NPI Number: 1073798674
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1093772
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name YOSEMITE STREET DIALYSIS CENTER
Street 1650 WEST YOSEMITE AVENUE
City MANTECA
State CA
ZIP 95337
Phone 209 824-5552
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2024
Certificate Expiration Date 12/30/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MEHUL RAVAL MD

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