LOS ANGELES DIALYSIS CENTER
NPI 1841547460
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Los Angeles, CA

Active since August 14, 2012CLIA 05D0663605 · Waiver
3901 S WESTERN AVE, LOS ANGELES, CA 90062(323) 294-0670(323) 294-0499 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 16, 2024, Jun 15, 2023, Sep 3, 2020 and 1 more (4 updates tracked since 2019).

About Los Angeles Dialysis Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOS ANGELES DIALYSIS CENTER (NPI 1841547460) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Los Angeles, California and active in the NPI registry since August 2012. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Samuel T. Wey, Vp, Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1841547460
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameGLASSLAND DIALYSIS LLC
Location Address3901 S WESTERN AVELos Angeles, CA 90062-1112
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Fax(323) 294-0499
Organization SubpartNo
Authorized OfficialSamuel T. WeyVp, Licensure & Certification · (615) 341-6641
Enumeration DateAugust 14, 2012
Last NPPES UpdateJuly 16, 20244 updates tracked since enumeration
NPPES CertifiedJuly 16, 2024
NPI 1841547460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
License Licensed in CA · 930000446
3901 S WESTERN AVE, Los Angeles, CA 90062

Other Names 1

Doing Business AsLos Angeles Dialysis Center

Other Identifiers 1

Medicaid1841547460CA

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0663605

Los Angeles Dialysis Center · Los Angeles, CA
Active · expires Aug 31, 2026
CLIA Number05D0663605
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJack Rubin MD
Laboratory Phone(323) 294-0670
Laboratory LocationLos Angeles Dialysis Center3901 S Western Ave, Los Angeles, CA 90062
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Addiction (Substance Use Disorder))
3901 S WESTERN AVE
LOS ANGELES, CA 90062
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
3901 S WESTERN AVE
LOS ANGELES, CA 90062

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glassland Dialysis LLC's NPI number?

The NPI number for Glassland Dialysis LLC is 1841547460. It was assigned to this organization in the NPPES registry on August 14, 2012. The provider is doing business as Los Angeles Dialysis Center.

Where is Glassland Dialysis LLC located?

Glassland Dialysis LLC is located at 3901 S Western Ave, Los Angeles, CA 90062. The listed phone number is (323) 294-0670.

What is Glassland Dialysis LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Glassland Dialysis LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0663605) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Glassland Dialysis LLC accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan and UnitedHealthcare list Glassland Dialysis LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glassland Dialysis LLC was last updated on July 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.