05D2059361 CLIA NUMBER - FIRESTONE BLVD DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2059361
  • Facility Name: FIRESTONE BLVD DIALYSIS
  • Facility Address: 11913 FIRESTONE BLVD
    NORWALK, CA
    ZIP 90650
  • Facility Phone: 562 863-2127
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SITA YANAMADALA
  • NPI Number: 1831433986
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2059361
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FIRESTONE BLVD DIALYSIS
Street 11913 FIRESTONE BLVD
City NORWALK
State CA
ZIP 90650
Phone 562 863-2127
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SITA YANAMADALA

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