05D2087017 CLIA NUMBER - ROSEVILLE DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2087017
  • Facility Name: ROSEVILLE DIALYSIS
  • Facility Address: 1836 SIERRA GARDENS DR STE 150
    ROSEVILLE, CA
    ZIP 95661
  • Facility Phone: 916 772-0306
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ANNIE C. YU
  • NPI Number: 1942625132
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2087017
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ROSEVILLE DIALYSIS
Street 1836 SIERRA GARDENS DR STE 150
City ROSEVILLE
State CA
ZIP 95661
Phone 916 772-0306
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ANNIE C. YU

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