05D0575267 CLIA NUMBER - LASALLE MEDICAL ASSOCIATES

Laboratory Demographics

CLIA Number: 05D0575267

Facility Name: LASALLE MEDICAL ASSOCIATES

Facility Address:
1505 W 17TH STREET
SAN BERNARDINO, CA
ZIP 92411
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Facility Phone Number: (909) 887-6494

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1548398142

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 05D0575267
LAB Type PHYSICIAN OFFICE
Facility Name LASALLE MEDICAL ASSOCIATES
Street 1505 W 17TH STREET
City SAN BERNARDINO
State CA
ZIP 92411
Phone (909) 887-6494

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