05D2068010 CLIA NUMBER - SAN LEANDRO MARINA DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2068010
  • Facility Name: SAN LEANDRO MARINA DIALYSIS
  • Facility Address: 2551 MERCED ST
    SAN LEANDRO, CA
    ZIP 94577
  • Facility Phone: 510 352-1207
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KATHRYN WELTY
  • NPI Number: 1316387954
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2068010
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SAN LEANDRO MARINA DIALYSIS
Street 2551 MERCED ST
City SAN LEANDRO
State CA
ZIP 94577
Phone 510 352-1207
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KATHRYN WELTY

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