05D2068431 CLIA NUMBER - BASTANCHURY DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2068431
  • Facility Name: BASTANCHURY DIALYSIS
  • Facility Address: 1950 SUNNYCREST DR, STE 1300
    FULLERTON, CA
    ZIP 92835
  • Facility Phone: 714 578-0018
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: NANCY HERNANDEZ
  • NPI Number: 1154755163
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2068431
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BASTANCHURY DIALYSIS
Street 1950 SUNNYCREST DR, STE 1300
City FULLERTON
State CA
ZIP 92835
Phone 714 578-0018
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director NANCY HERNANDEZ

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