05D0580417 CLIA NUMBER - JERRY S BENZL MD

Laboratory Demographics

  • CLIA Code: 05D0580417
  • Facility Name: JERRY S BENZL MD
  • Facility Address: 26902 OSO PARKWAY STE 180
    MISSION VIEJO, CA
    ZIP 92691
  • Facility Phone: 949 364-1233
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JERRY S. BENZL
  • NPI Number: 1740398148
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0580417
LAB Type Physician Office
Facility Name JERRY S BENZL MD
Street 26902 OSO PARKWAY STE 180
City MISSION VIEJO
State CA
ZIP 92691
Phone 949 364-1233
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JERRY S. BENZL

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