05D0865338 CLIA NUMBER - SAN BUENAVENTURA UROLOGY IN ASSOCIATION WITH COMMUNITY MEMORIAL HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0865338
  • Facility Name: SAN BUENAVENTURA UROLOGY IN ASSOCIATION WITH COMMUNITY MEMORIAL HOSPITAL
  • Facility Address: 2705 LOMA VISTA RD #206
    VENTURA, CA
    ZIP 93003
  • Facility Phone: 805 643-4067
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARC A. BEAGHLER
  • NPI Number: 1730498411
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0865338
LAB Type Physician Office
Facility Name SAN BUENAVENTURA UROLOGY IN ASSOCIATION WITH COMMUNITY MEMORIAL HOSPITAL
Street 2705 LOMA VISTA RD #206
City VENTURA
State CA
ZIP 93003
Phone 805 643-4067
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 MARC A. BEAGHLER

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