05D0585439 CLIA NUMBER - RAJ H DWIVEDI

Laboratory Demographics

  • CLIA Code: 05D0585439
  • Facility Name: RAJ H DWIVEDI
  • Facility Address: 623 W PUTNAM AVE
    PORTERVILLE, CA
    ZIP 93257
  • Facility Phone: 209 781-2403
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJ DWIVEDI
  • NPI Number: 1417027061
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 05D0585439
LAB Type Physician Office
Facility Name RAJ H DWIVEDI
Street 623 W PUTNAM AVE
City PORTERVILLE
State CA
ZIP 93257
Phone 209 781-2403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Physician Office
Lab Director RAJ DWIVEDI

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