05D2150341 CLIA NUMBER - HOME DIALYSIS OF RANCHO CUCAMONGA

Laboratory Demographics

  • CLIA Code: 05D2150341
  • Facility Name: HOME DIALYSIS OF RANCHO CUCAMONGA
  • Facility Address: 8239 ROCHESTER BLVD. SUITE 110
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 909 945-2104
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAFFI MINASIAN, MD
  • NPI Number: 1720314982
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2150341
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name HOME DIALYSIS OF RANCHO CUCAMONGA
Street 8239 ROCHESTER BLVD. SUITE 110
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 909 945-2104
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAFFI MINASIAN, MD

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This page was last updated on: 6/4/2025