05D2013939 CLIA NUMBER - ANAHEIM WEST DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2013939
  • Facility Name: ANAHEIM WEST DIALYSIS
  • Facility Address: 1821 WEST LINCOLN AVE
    ANAHEIM, CA
    ZIP 92801
  • Facility Phone: 714 765-6510
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ISMAIL MOHAMMAD
  • NPI Number: 1033449459
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2013939
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ANAHEIM WEST DIALYSIS
Street 1821 WEST LINCOLN AVE
City ANAHEIM
State CA
ZIP 92801
Phone 714 765-6510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ISMAIL MOHAMMAD

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