05D2297183 CLIA NUMBER - USRC LOS BANOS HOME, LLC US RENAL CARE LOS BANOS HOME PROGRAM

Laboratory Demographics

  • CLIA Code: 05D2297183
  • Facility Name: USRC LOS BANOS HOME, LLC US RENAL CARE LOS BANOS HOME PROGRAM
  • Facility Address: 1451 W PACHECO BLVD STE G
    LOS BANOS, CA
    ZIP 93635
  • Facility Phone: 209 774-4211
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ROY T. ATULKUMAR
  • NPI Number: 1972287605
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2297183
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name USRC LOS BANOS HOME, LLC US RENAL CARE LOS BANOS HOME PROGRAM
Street 1451 W PACHECO BLVD STE G
City LOS BANOS
State CA
ZIP 93635
Phone 209 774-4211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ROY T. ATULKUMAR

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