05D2153329 CLIA NUMBER - VISTA HEIGHTS DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2153329
  • Facility Name: VISTA HEIGHTS DIALYSIS
  • Facility Address: 12220 PERRIS BOULEVARD
    MORENO VALLEY, CA
    ZIP 92557
  • Facility Phone: 925 427-0867
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SALAM ISHAK
  • NPI Number: 1730631045
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2153329
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name VISTA HEIGHTS DIALYSIS
Street 12220 PERRIS BOULEVARD
City MORENO VALLEY
State CA
ZIP 92557
Phone 925 427-0867
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SALAM ISHAK

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