05D0573056 CLIA NUMBER - MA MENON MD

Laboratory Demographics

CLIA Number: 05D0573056

Facility Name: MA MENON MD

Facility Address:
18056 WIKA RD STE A
APPLE VALLEY, CA
ZIP 92307
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Facility Phone Number: (760) 242-1090

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

CLIA Record

Field Name Field Value
CLIA Number 05D0573056
LAB Type PHYSICIAN OFFICE
Facility Name MA MENON MD
Street 18056 WIKA RD STE A
City APPLE VALLEY
State CA
ZIP 92307
Phone (760) 242-1090

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This page was last updated on: 1/7/2022