05D2167318 CLIA NUMBER - TRICITY RIVERSIDE DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2167318
  • Facility Name: TRICITY RIVERSIDE DIALYSIS
  • Facility Address: 7275 INDIANA AVE STE 100
    RIVERSIDE, CA
    ZIP 92504
  • Facility Phone: 951 354-3966
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MOHAMMED KHAN
  • NPI Number: 1003396615
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2167318
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TRICITY RIVERSIDE DIALYSIS
Street 7275 INDIANA AVE STE 100
City RIVERSIDE
State CA
ZIP 92504
Phone 951 354-3966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MOHAMMED KHAN

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