05D2106358 CLIA NUMBER - SANTA CLARITA DIALYSIS LLC

Laboratory Demographics

CLIA Number: 05D2106358

Facility Name: SANTA CLARITA DIALYSIS LLC

Facility Address:
23421 LYONS AVE
SANTA CLARITA, CA
ZIP 91355
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Facility Phone Number: 818 365-1194

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1083087928

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2106358
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SANTA CLARITA DIALYSIS LLC
Street	23421 LYONS AVE
City	SANTA CLARITA
State	CA
ZIP	91355
Phone	818 365-1194
CertificateType	4
CertificateEffectiveDate	12/16/2023
CertificateExpirationDate	12/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024