05D2150076 CLIA NUMBER - CAPITAL NEPHROLOGY ACCESS CTR LLC

Laboratory Demographics

CLIA Number: 05D2150076

Facility Name: CAPITAL NEPHROLOGY ACCESS CTR LLC

Facility Address:
1111 EXPOSITION BLVD STE 300
SACRAMENTO, CA
ZIP 95815
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Facility Phone Number: 916 564-6232

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1275060303

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2150076
LAB Type	Ambulatory Surgery Center
Facility Name	CAPITAL NEPHROLOGY ACCESS CTR LLC
Street	1111 EXPOSITION BLVD STE 300
City	SACRAMENTO
State	CA
ZIP	95815
Phone	916 564-6232
CertificateType	4
CertificateEffectiveDate	6/15/2022
CertificateExpirationDate	6/14/2024
FacilityType	Waiver

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