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: 1053417725

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: 1/7/2022