05D0901899 CLIA NUMBER - NARESH J GANESH, MD

Laboratory Demographics

CLIA Number: 05D0901899

Facility Name: NARESH J GANESH, MD

Facility Address:
15982 TUSCOLA ROAD, SUITE A
APPLE VALLEY, CA
ZIP 92307
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Facility Phone Number: 760 946-4600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558468942

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0901899
LAB Type	Physician Office
Facility Name	NARESH J GANESH, MD
Street	15982 TUSCOLA ROAD, SUITE A
City	APPLE VALLEY
State	CA
ZIP	92307
Phone	760 946-4600
CertificateType	4
CertificateEffectiveDate	9/9/2022
CertificateExpirationDate	9/8/2024
FacilityType	Waiver

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