05D1104144 CLIA NUMBER - LIVERMORE DIALYSIS

Laboratory Demographics

CLIA Number: 05D1104144

Facility Name: LIVERMORE DIALYSIS

Facility Address:
3201 DOOLAN RD SUITE 175
LIVERMORE, CA
ZIP 94551
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Facility Phone Number: 925 245-9780

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1700029642

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1104144
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LIVERMORE DIALYSIS
Street	3201 DOOLAN RD SUITE 175
City	LIVERMORE
State	CA
ZIP	94551
Phone	925 245-9780
CertificateType	4
CertificateEffectiveDate	8/26/2023
CertificateExpirationDate	8/25/2025
FacilityType	Waiver

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