05D2187334 CLIA NUMBER - SATELLITE HEALTHCARE KATELLA ORANGE

Laboratory Demographics

CLIA Number: 05D2187334

Facility Name: SATELLITE HEALTHCARE KATELLA ORANGE

Facility Address:
1536 E KATELLA AVENUE
ORANGE, CA
ZIP 92867
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Facility Phone Number: 714 912-8683

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1760011274

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2187334
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SATELLITE HEALTHCARE KATELLA ORANGE
Street	1536 E KATELLA AVENUE
City	ORANGE
State	CA
ZIP	92867
Phone	714 912-8683
CertificateType	4
CertificateEffectiveDate	6/29/2022
CertificateExpirationDate	6/28/2024
FacilityType	Waiver

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