05D0680379 CLIA NUMBER - DOCTORS URGENT CARE MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D0680379

Facility Name: DOCTORS URGENT CARE MEDICAL GROUP

Facility Address:
120 S MONTEBELLO BLVD
MONTEBELLO, CA
ZIP 90640
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Facility Phone Number: 323 726-0533

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477698512

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	05D0680379
LAB Type	Physician Office
Facility Name	DOCTORS URGENT CARE MEDICAL GROUP
Street	120 S MONTEBELLO BLVD
City	MONTEBELLO
State	CA
ZIP	90640
Phone	323 726-0533
CertificateType	4
CertificateEffectiveDate	9/7/2023
CertificateExpirationDate	9/6/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024