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EHD Program Facility Records by Street Name
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FAIRMONT
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4500 - Medical Waste Program
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PR0526720
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Last modified
12/29/2022 3:47:06 PM
Creation date
12/29/2022 12:45:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
BILLING/PERMITS
RECORD_ID
PR0526720
PE
4530
FACILITY_ID
FA0018092
FACILITY_NAME
DAVITA TOKAY DIALYSIS CENTER
STREET_NUMBER
312
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
952403840
APN
03311030
CURRENT_STATUS
01
SITE_LOCATION
312 S FAIRMONT AVE STE A
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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SAN JOAQUIN COUNTY;E iV)I ON MENTAL HEALTH DEPARTMENT <br /> ..600.E. Maid St. to Stockton!CA.OR02-3029 9.Phone f 209)468-3420 <br /> Doting Heran R.E.H.S,,:Director <br /> PERMIT T OPERATE - 4530 i. QUANITY GENERATOR <br /> Permit ID# PT0018689 for Record:Ip#PR0526720 <br /> VAN From 11.112008 To. 12/3172008 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or 107VOIKEP,for cause. <br /> PERMIT(s),Valid only,for:, .DAVITA'INC <br /> THIS FORM;i a IRE DISPLAYED CONSPICUOUSLY ON:THE PREMISES <br /> Regulated Facility: DAVITA TOKAY DIiALYSiS CENTER Fadlity,11) FA0018092 <br /> 312.S FAIRMONT`AVE#A - <br /> Account!D AR0031820 <br /> " <br /> LOM CA"�9524U-.3840. <br /> Issued" 11/29/2007 <br /> Billing Address: ATTN LICENSURE&CERTIFICATION DEPT <br /> DAVITA TOKAY�DIALYSIS CENTER <br /> 5200 VIRGINIA WAY <br /> QRENTWOOD -TN 370 7 <br />
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