05D2100865 CLIA NUMBER - SOUTH GATE DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2100865
  • Facility Name: SOUTH GATE DIALYSIS
  • Facility Address: 9848 ATLANTIC AVE
    SOUTH GATE, CA
    ZIP 90280
  • Facility Phone: 323 569-1035
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: WEN-YUAN CHIANG, DO
  • NPI Number: 1184004137
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2100865
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTH GATE DIALYSIS
Street 9848 ATLANTIC AVE
City SOUTH GATE
State CA
ZIP 90280
Phone 323 569-1035
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director WEN-YUAN CHIANG, DO

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