05D2106623 CLIA NUMBER - BROADWAY DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2106623
  • Facility Name: BROADWAY DIALYSIS
  • Facility Address: 2624 STOCKTON BLVD
    SACRAMENTO, CA
    ZIP 95817
  • Facility Phone: 916 457-0013
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ERIC CHANG
  • NPI Number: 1821082504
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 05D2106623
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BROADWAY DIALYSIS
Street 2624 STOCKTON BLVD
City SACRAMENTO
State CA
ZIP 95817
Phone 916 457-0013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ERIC CHANG

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