05D2025578 CLIA NUMBER - OXNARD DIALYSIS

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Laboratory Demographics

CLIA Number: 05D2025578

Facility Name: OXNARD DIALYSIS

Facility Address:
1900 OUTLET CENTER DR
OXNARD, CA
ZIP 93036
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Facility Phone Number: 805 278-3815

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1629388855

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2025578
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	OXNARD DIALYSIS
Street	1900 OUTLET CENTER DR
City	OXNARD
State	CA
ZIP	93036
Phone	805 278-3815
CertificateType	4
CertificateEffectiveDate	6/13/2023
CertificateExpirationDate	6/12/2025
FacilityType	Waiver

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