05D2085304 CLIA NUMBER - CASA ST HOME TRAINING

Laboratory Demographics

  • CLIA Code: 05D2085304
  • Facility Name: CASA ST HOME TRAINING
  • Facility Address: 35 CASA ST STE 110
    SAN LUIS OBISPO, CA
    ZIP 93405
  • Facility Phone: 805 785-0321
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BRIAN PENTON
  • NPI Number: 1477961696
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2085304
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CASA ST HOME TRAINING
Street 35 CASA ST STE 110
City SAN LUIS OBISPO
State CA
ZIP 93405
Phone 805 785-0321
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BRIAN PENTON

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