05D0558608 CLIA NUMBER - SYLMAR MEDICAL CENTER

Laboratory Demographics

CLIA Number: 05D0558608

Facility Name: SYLMAR MEDICAL CENTER

Facility Address:
14124 FOOTHILL BLVD STE 100
SYLMAR, CA
ZIP 91342
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Facility Phone Number: 818 367-1012

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790716447

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0558608
LAB Type	Physician Office
Facility Name	SYLMAR MEDICAL CENTER
Street	14124 FOOTHILL BLVD STE 100
City	SYLMAR
State	CA
ZIP	91342
Phone	818 367-1012
CertificateType	4
CertificateEffectiveDate	4/5/2024
CertificateExpirationDate	4/4/2026
FacilityType	Waiver

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