05D0579478 CLIA NUMBER - SAN CLEMENTE MEDI-CENTER

Laboratory Demographics

CLIA Number: 05D0579478

Facility Name: SAN CLEMENTE MEDI-CENTER

Facility Address:
910 S EL CAMINO REAL
SAN CLEMENTE, CA
ZIP 92672
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Facility Phone Number: (714) 492-4994

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1639268139

Taxonomy: 207PE0004X - Emergency Medicine
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

CLIA Record

Field Name Field Value
CLIA Number 05D0579478
LAB Type PHYSICIAN OFFICE
Facility Name SAN CLEMENTE MEDI-CENTER
Street 910 S EL CAMINO REAL
City SAN CLEMENTE
State CA
ZIP 92672
Phone (714) 492-4994

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