05D2176968 CLIA NUMBER - UNIVERSAL HUNTINGTON PARK DIALYSIS

Laboratory Demographics

  • CLIA Code: 05D2176968
  • Facility Name: UNIVERSAL HUNTINGTON PARK DIALYSIS
  • Facility Address: 1824 EAST SLAUSON AVENUE
    VERNON, CA
    ZIP 90058
  • Facility Phone: 323 364-0188
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DORSA MARYSKA MD
  • NPI Number: 1104476175
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2176968
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name UNIVERSAL HUNTINGTON PARK DIALYSIS
Street 1824 EAST SLAUSON AVENUE
City VERNON
State CA
ZIP 90058
Phone 323 364-0188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2023
Certificate Expiration Date 12/30/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DORSA MARYSKA MD

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