05D2129461 CLIA NUMBER - HARBOR VERMONT HOME TRAINING

Laboratory Demographics

CLIA Number: 05D2129461

Facility Name: HARBOR VERMONT HOME TRAINING

Facility Address:
21608 S VERMONT AVE
TORRANCE, CA
ZIP 90502
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Facility Phone Number: 310 212-7529

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1447624200

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2129461
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HARBOR VERMONT HOME TRAINING
Street	21608 S VERMONT AVE
City	TORRANCE
State	CA
ZIP	90502
Phone	310 212-7529
CertificateType	4
CertificateEffectiveDate	4/19/2023
CertificateExpirationDate	4/18/2025
FacilityType	Waiver

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