05D2059361 CLIA NUMBER - FIRESTONE BLVD DIALYSIS

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Laboratory Demographics

CLIA Number: 05D2059361

Facility Name: FIRESTONE BLVD DIALYSIS

Facility Address:
11913 FIRESTONE BLVD
NORWALK, CA
ZIP 90650
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Facility Phone Number: (562) 863-2127

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1831433986

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2059361
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	FIRESTONE BLVD DIALYSIS
Street	11913 FIRESTONE BLVD
City	NORWALK
State	CA
ZIP	90650
Phone	(562) 863-2127

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This page was last updated on: 5/11/2023