05D0568909 CLIA NUMBER - IRVING A BLOOM MD

Laboratory Demographics

  • CLIA Code: 05D0568909
  • Facility Name: IRVING A BLOOM MD
  • Facility Address: 130 CEDAR ROAD #310
    VISTA, CA
    ZIP 92083
  • Facility Phone: 760 630-9095
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IRVING A. BLOOM MD
  • NPI Number: 1679664502
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0568909
LAB Type Physician Office
Facility Name IRVING A BLOOM MD
Street 130 CEDAR ROAD #310
City VISTA
State CA
ZIP 92083
Phone 760 630-9095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director IRVING A. BLOOM MD

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This page was last updated on: 9/29/2025