05D2045004 CLIA NUMBER - SUN CITY MENIFEE DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2045004
  • Facility Name: SUN CITY MENIFEE DIALYSIS
  • Facility Address: 1702 ILLINOIS AVE
    PERRIS, CA
    ZIP 92571
  • Facility Phone: 951 928-1369
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. ERIC YAN MD
  • NPI Number: 1225302128
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2045004
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SUN CITY MENIFEE DIALYSIS
Street 1702 ILLINOIS AVE
City PERRIS
State CA
ZIP 92571
Phone 951 928-1369
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2024
Certificate Expiration Date 8/2/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. ERIC YAN MD

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