05D2070199 CLIA NUMBER - NEWPORT SUPERIOR DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2070199
  • Facility Name: NEWPORT SUPERIOR DIALYSIS
  • Facility Address: 510 SUPERIOR AVE STE 150
    NEWPORT BEACH, CA
    ZIP 92663
  • Facility Phone: 949 574-4733
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: GLENN CHIANG
  • NPI Number: 1275876351
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2070199
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NEWPORT SUPERIOR DIALYSIS
Street 510 SUPERIOR AVE STE 150
City NEWPORT BEACH
State CA
ZIP 92663
Phone 949 574-4733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director GLENN CHIANG

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