05D2106494 CLIA NUMBER - DAVITA HUNTINGTON DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2106494
  • Facility Name: DAVITA HUNTINGTON DIALYSIS
  • Facility Address: 390 S FAIR OAKS AVE STE 120
    PASADENA, CA
    ZIP 91105
  • Facility Phone: 626 564-2818
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ANNE MOORE
  • NPI Number: 1457742678
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2106494
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DAVITA HUNTINGTON DIALYSIS
Street 390 S FAIR OAKS AVE STE 120
City PASADENA
State CA
ZIP 91105
Phone 626 564-2818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ANNE MOORE

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