05D2183536 CLIA NUMBER - OAKLAND BROADWAY DIALYSIS

Laboratory Demographics

CLIA Number: 05D2183536

Facility Name: OAKLAND BROADWAY DIALYSIS

Facility Address:
4242 BROADWAY
OAKLAND, CA
ZIP 94611
Get Directions

Facility Phone Number: 510 654-4645

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1831615855

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2183536
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	OAKLAND BROADWAY DIALYSIS
Street	4242 BROADWAY
City	OAKLAND
State	CA
ZIP	94611
Phone	510 654-4645
CertificateType	4
CertificateEffectiveDate	5/6/2022
CertificateExpirationDate	5/5/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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