05D0889314 CLIA NUMBER - SCPMG STOCKDALE MEDICAL OFFICES

Laboratory Demographics

  • CLIA Code: 05D0889314
  • Facility Name: SCPMG STOCKDALE MEDICAL OFFICES
  • Facility Address: 3501 STOCKDALE HIGHWAY
    BAKERSFIELD, CA
    ZIP 93309
  • Facility Phone: 661 827-3001
  • Facility Type: Health Main. Organization
  • Facility Type: Microscopy
  • Lab Director: INGA ASTAKHOVA
  • NPI Number: 1669806402
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 05D0889314
LAB Type Health Main. Organization
Facility Name SCPMG STOCKDALE MEDICAL OFFICES
Street 3501 STOCKDALE HIGHWAY
City BAKERSFIELD
State CA
ZIP 93309
Phone 661 827-3001
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 7/25/2024
Certificate Expiration Date 7/24/2026
Facility Type Health Main. Organization
Lab Director INGA ASTAKHOVA

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