05D2275261 CLIA NUMBER - WYATT DIALYSIS LLC DBA NAPA HOME TRAINING

Laboratory Demographics

CLIA Number: 05D2275261

Facility Name: WYATT DIALYSIS LLC DBA NAPA HOME TRAINING

Facility Address:
3350 CALIFORNIA BLVD, SUITE A
NAPA, CA
ZIP 94558
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Facility Phone Number: 707 562-4446

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1972252187

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2275261
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	WYATT DIALYSIS LLC DBA NAPA HOME TRAINING
Street	3350 CALIFORNIA BLVD, SUITE A
City	NAPA
State	CA
ZIP	94558
Phone	707 562-4446
CertificateType	4
CertificateEffectiveDate	1/18/2023
CertificateExpirationDate	1/17/2025
FacilityType	Waiver

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