05D2048411 CLIA NUMBER - MOORPARK DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2048411
  • Facility Name: MOORPARK DIALYSIS
  • Facility Address: 883 PATRIOR DR., STE. C
    MOORPARK, CA
    ZIP 93021
  • Facility Phone: 805 517-1442
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JIESHI YAN
  • NPI Number: 1184048506
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2048411
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MOORPARK DIALYSIS
Street 883 PATRIOR DR., STE. C
City MOORPARK
State CA
ZIP 93021
Phone 805 517-1442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JIESHI YAN

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