05D0684277 CLIA NUMBER - VALLEY VIEW FAMILY MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 05D0684277

Facility Name: VALLEY VIEW FAMILY MEDICAL CLINIC

Facility Address:
9608 VAN NUYS BLVD SUITE 104
PANORAMA CITY, CA
ZIP 91402
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Facility Phone Number: 818 830-6888

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194912741

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	05D0684277
LAB Type	Physician Office
Facility Name	VALLEY VIEW FAMILY MEDICAL CLINIC
Street	9608 VAN NUYS BLVD SUITE 104
City	PANORAMA CITY
State	CA
ZIP	91402
Phone	818 830-6888
CertificateType	4
CertificateEffectiveDate	12/25/2023
CertificateExpirationDate	12/24/2025
FacilityType	Waiver

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