05D2122019 CLIA NUMBER - PALMS VALLEY DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2122019
  • Facility Name: PALMS VALLEY DIALYSIS
  • Facility Address: 38454 5TH ST W
    PALMDALE, CA
    ZIP 93551
  • Facility Phone: 661 328-0157
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RENDELL MANALO
  • NPI Number: 1528421724
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2122019
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PALMS VALLEY DIALYSIS
Street 38454 5TH ST W
City PALMDALE
State CA
ZIP 93551
Phone 661 328-0157
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2024
Certificate Expiration Date 11/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RENDELL MANALO

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