05D1015752 CLIA NUMBER - WELLBOUND OF MENLO PARK, LLC DBA SATELLITE WELLBOUND OF FREMONT

Laboratory Demographics

  • CLIA Code: 05D1015752
  • Facility Name: WELLBOUND OF MENLO PARK, LLC DBA SATELLITE WELLBOUND OF FREMONT
  • Facility Address: 39510 PASEO PADRE PARKWAY, SUITE 100
    FREMONT, CA
    ZIP 94538
  • Facility Phone: 510 953-7800
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: LUIS ALVAREZ, MD
  • NPI Number: 1144292186
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1015752
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WELLBOUND OF MENLO PARK, LLC DBA SATELLITE WELLBOUND OF FREMONT
Street 39510 PASEO PADRE PARKWAY, SUITE 100
City FREMONT
State CA
ZIP 94538
Phone 510 953-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director LUIS ALVAREZ, MD

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This page was last updated on: 6/4/2025