05D2052794 CLIA NUMBER - WELLBOUND OF SANTA CRUZ

Laboratory Demographics

  • CLIA Code: 05D2052794
  • Facility Name: WELLBOUND OF SANTA CRUZ
  • Facility Address: 2128 SOQUEL AVE.
    SANTA CRUZ, CA
    ZIP 95062
  • Facility Phone: 831 600-4840
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHRADDHA RANA
  • NPI Number: 1669741468
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2052794
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WELLBOUND OF SANTA CRUZ
Street 2128 SOQUEL AVE.
City SANTA CRUZ
State CA
ZIP 95062
Phone 831 600-4840
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHRADDHA RANA

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This page was last updated on: 6/4/2025