05D2029742 CLIA NUMBER - RICHMOND DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2029742
  • Facility Name: RICHMOND DIALYSIS
  • Facility Address: 4200 MACDONALD AVENUE, SUITE A
    RICHMOND, CA
    ZIP 94805
  • Facility Phone: 510 236-8861
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MARIA ENRICA D. PAGTALUNAN
  • NPI Number: 1205135340
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2029742
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RICHMOND DIALYSIS
Street 4200 MACDONALD AVENUE, SUITE A
City RICHMOND
State CA
ZIP 94805
Phone 510 236-8861
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MARIA ENRICA D. PAGTALUNAN

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