05D0710804 CLIA NUMBER - WEST HILLS FAMILY PRACTICE AGOURA

Laboratory Demographics

  • CLIA Code: 05D0710804
  • Facility Name: WEST HILLS FAMILY PRACTICE AGOURA
  • Facility Address: 30300 AGOURA RD STE 200
    AGOURA HILLS, CA
    ZIP 91301
  • Facility Phone: 818 707-7789
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BARRY J. WALLMAN, MD
  • NPI Number: 1154491934
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0710804
LAB Type Physician Office
Facility Name WEST HILLS FAMILY PRACTICE AGOURA
Street 30300 AGOURA RD STE 200
City AGOURA HILLS
State CA
ZIP 91301
Phone 818 707-7789
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director BARRY J. WALLMAN, MD

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