05D2001316 CLIA NUMBER - NORTH GLENDALE DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2001316
  • Facility Name: NORTH GLENDALE DIALYSIS
  • Facility Address: 1505 WILSON TERRACE STE 190
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 637-8348
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SAM F. DANESHVARI, MD
  • NPI Number: 1629200134
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2001316
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NORTH GLENDALE DIALYSIS
Street 1505 WILSON TERRACE STE 190
City GLENDALE
State CA
ZIP 91206
Phone 818 637-8348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SAM F. DANESHVARI, MD

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