05D0557570 CLIA NUMBER - AGOURA-WEST VALLEY PEDIATRIC MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D0557570

Facility Name: AGOURA-WEST VALLEY PEDIATRIC MEDICAL GROUP

Facility Address:
7320 WOODLAKE AVE, STE 270
WEST HILLS, CA
ZIP 91307
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Facility Phone Number: 818 340-3822

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1730108366

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	05D0557570
LAB Type	Physician Office
Facility Name	AGOURA-WEST VALLEY PEDIATRIC MEDICAL GROUP
Street	7320 WOODLAKE AVE, STE 270
City	WEST HILLS
State	CA
ZIP	91307
Phone	818 340-3822
CertificateType	4
CertificateEffectiveDate	2/4/2024
CertificateExpirationDate	2/3/2026
FacilityType	Waiver

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