05D2083877 CLIA NUMBER - GARDEN GROVE HARBOR DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2083877
  • Facility Name: GARDEN GROVE HARBOR DIALYSIS
  • Facility Address: 13054 N HARBOR BLVD
    GARDEN GROVE, CA
    ZIP 92843
  • Facility Phone: 714 539-3395
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD ISMAIL MD
  • NPI Number: 1619397700
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2083877
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GARDEN GROVE HARBOR DIALYSIS
Street 13054 N HARBOR BLVD
City GARDEN GROVE
State CA
ZIP 92843
Phone 714 539-3395
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2024
Certificate Expiration Date 9/14/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MOHAMMAD ISMAIL MD

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