05D2010298 CLIA NUMBER - CALVINE DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2010298
  • Facility Name: CALVINE DIALYSIS
  • Facility Address: 8243 E STOCKTON BLVD STE 100
    SACRAMENTO, CA
    ZIP 95828
  • Facility Phone: 916 682-6655
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JOHAN WINOTO
  • NPI Number: 1093030504
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2010298
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CALVINE DIALYSIS
Street 8243 E STOCKTON BLVD STE 100
City SACRAMENTO
State CA
ZIP 95828
Phone 916 682-6655
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JOHAN WINOTO

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