05D0878882 CLIA NUMBER - PREVENTIVE MEDICINE CLINICS

Laboratory Demographics

CLIA Number: 05D0878882

Facility Name: PREVENTIVE MEDICINE CLINICS

Facility Address:
3001 E TAHQUITZ CANYON STE 108
PALM SPRINGS, CA
ZIP 92262
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Facility Phone Number: (760) 320-4292

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1114135415

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	05D0878882
LAB Type	PHYSICIAN OFFICE
Facility Name	PREVENTIVE MEDICINE CLINICS
Street	3001 E TAHQUITZ CANYON STE 108
City	PALM SPRINGS
State	CA
ZIP	92262
Phone	(760) 320-4292

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This page was last updated on: 5/11/2023