05D0581639 CLIA NUMBER - FOUNTAIN VALLEY CARDIOLOGY MEDICAL CLINIC, INC

Laboratory Demographics

CLIA Number: 05D0581639

Facility Name: FOUNTAIN VALLEY CARDIOLOGY MEDICAL CLINIC, INC

Facility Address:
11100 WARNER AVE #268
FOUNTAIN VALLEY, CA
ZIP 92708
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Facility Phone Number: (714) 540-9911

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1912029901

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	05D0581639
LAB Type	PHYSICIAN OFFICE
Facility Name	FOUNTAIN VALLEY CARDIOLOGY MEDICAL CLINIC, INC
Street	11100 WARNER AVE #268
City	FOUNTAIN VALLEY
State	CA
ZIP	92708
Phone	(714) 540-9911

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This page was last updated on: 5/11/2023