05D0584061 CLIA NUMBER - GARY D WIKHOLM MD PC

Laboratory Demographics

CLIA Number: 05D0584061

Facility Name: GARY D WIKHOLM MD PC

Facility Address:
247 WEST HARVARD BOULEVARD
SANTA PAULA, CA
ZIP 93060
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Facility Phone Number: (805) 525-0907

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1861598526

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0584061
LAB Type	PHYSICIAN OFFICE
Facility Name	GARY D WIKHOLM MD PC
Street	247 WEST HARVARD BOULEVARD
City	SANTA PAULA
State	CA
ZIP	93060
Phone	(805) 525-0907

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