05D0562618 CLIA NUMBER - RANDOLPH J BETTS, MD FAMILY PRACTICE MEDICAL CORP

Laboratory Demographics

CLIA Number: 05D0562618

Facility Name: RANDOLPH J BETTS, MD FAMILY PRACTICE MEDICAL CORP

Facility Address:
274 W BADILLO STREET
COVINA, CA
ZIP 91723
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Facility Phone Number: 626 331-7369

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1932113685

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0562618
LAB Type	Physician Office
Facility Name	RANDOLPH J BETTS, MD FAMILY PRACTICE MEDICAL CORP
Street	274 W BADILLO STREET
City	COVINA
State	CA
ZIP	91723
Phone	626 331-7369
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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