05D0899795 CLIA NUMBER - JEAN BARDENHEIER, MD

Laboratory Demographics

  • CLIA Code: 05D0899795
  • Facility Name: JEAN BARDENHEIER, MD
  • Facility Address: 914 E GLADSTONE STREET
    AZUSA, CA
    ZIP 91702
  • Facility Phone: 818 966-4506
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEAN W. BARDENHEIER, MD
  • NPI Number: 1780620138
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0899795
LAB Type Physician Office
Facility Name JEAN BARDENHEIER, MD
Street 914 E GLADSTONE STREET
City AZUSA
State CA
ZIP 91702
Phone 818 966-4506
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 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director JEAN W. BARDENHEIER, MD

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