05D2066260 CLIA NUMBER - STEVENS CREEK DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2066260
  • Facility Name: STEVENS CREEK DIALYSIS
  • Facility Address: 275 DI SALVO AVE
    SAN JOSE, CA
    ZIP 95128
  • Facility Phone: 408 297-0103
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ADDY SQUARER
  • NPI Number: 1457797474
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2066260
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name STEVENS CREEK DIALYSIS
Street 275 DI SALVO AVE
City SAN JOSE
State CA
ZIP 95128
Phone 408 297-0103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ADDY SQUARER

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