05D2080355 CLIA NUMBER - BLUFF RD DIALYSIS

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Laboratory Demographics

CLIA Number: 05D2080355

Facility Name: BLUFF RD DIALYSIS

Facility Address:
100 W WASHINGTON BLVD
MONTEBELLO, CA
ZIP 90640
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Facility Phone Number: 714 523-5970

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1679990543

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2080355
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BLUFF RD DIALYSIS
Street	100 W WASHINGTON BLVD
City	MONTEBELLO
State	CA
ZIP	90640
Phone	714 523-5970
CertificateType	4
CertificateEffectiveDate	7/3/2022
CertificateExpirationDate	7/2/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024