05D2188936 CLIA NUMBER - ST FRANCIS DIALYSIS

Laboratory Demographics

CLIA Number: 05D2188936

Facility Name: ST FRANCIS DIALYSIS

Facility Address:
10211 LONG BEACH BLVD
LYNWOOD, CA
ZIP 90262
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Facility Phone Number: 213 460-0938

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1790308179

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2188936
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ST FRANCIS DIALYSIS
Street	10211 LONG BEACH BLVD
City	LYNWOOD
State	CA
ZIP	90262
Phone	213 460-0938
CertificateType	4
CertificateEffectiveDate	7/23/2022
CertificateExpirationDate	7/22/2024
FacilityType	Waiver

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