05D2104100 CLIA NUMBER - BARNNY JEPP, LLC D/B/A US RENAL CARE GRAND HOME PROGRAM

Laboratory Demographics

  • CLIA Code: 05D2104100
  • Facility Name: BARNNY JEPP, LLC D/B/A US RENAL CARE GRAND HOME PROGRAM
  • Facility Address: 1145 WEST 6TH ST
    LOS ANGELES, CA
    ZIP 90017
  • Facility Phone: 213 250-9758
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BRUCE A. GREENFIELD, MD
  • NPI Number: 1588031322
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2104100
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BARNNY JEPP, LLC D/B/A US RENAL CARE GRAND HOME PROGRAM
Street 1145 WEST 6TH ST
City LOS ANGELES
State CA
ZIP 90017
Phone 213 250-9758
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BRUCE A. GREENFIELD, MD

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