05D0584165 CLIA NUMBER - WALTER THOMAS MD

Laboratory Demographics

  • CLIA Code: 05D0584165
  • Facility Name: WALTER THOMAS MD
  • Facility Address: 1980 SEQUOIA AVE
    SIMI VALLEY, CA
    ZIP 93063
  • Facility Phone: 805 527-1804
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WALTER MD THOMAS
  • NPI Number: 1952379463
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0584165
LAB Type Physician Office
Facility Name WALTER THOMAS MD
Street 1980 SEQUOIA AVE
City SIMI VALLEY
State CA
ZIP 93063
Phone 805 527-1804
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director WALTER MD THOMAS

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This page was last updated on: 6/4/2025