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05D0900800 CLIA NUMBER - PARADISE MEDICAL GROUP - PEDIATRICS

Laboratory Demographics

CLIA Number: 05D0900800

Facility Name: PARADISE MEDICAL GROUP - PEDIATRICS

Facility Address:
1010 MANGROVE AVE SUITE A
CHICO, CA
ZIP 95926
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Facility Phone Number: 530 877-5437

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1235111006

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 05D0900800
LAB Type Physician Office
Facility Name PARADISE MEDICAL GROUP - PEDIATRICS
Street 1010 MANGROVE AVE SUITE A
City CHICO
State CA
ZIP 95926
Phone 530 877-5437
CertificateType 4
CertificateEffectiveDate 10/16/2023
CertificateExpirationDate 10/15/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024