05D0912212 CLIA NUMBER - SAN FERNANDO HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D0912212

Facility Name: SAN FERNANDO HEALTH CENTER

Facility Address:
1212 PICO ST
SAN FERNANDO, CA
ZIP 91340
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Facility Phone Number: 818 627-3050

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1558379990

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	05D0912212
LAB Type	Community Clinic
Facility Name	SAN FERNANDO HEALTH CENTER
Street	1212 PICO ST
City	SAN FERNANDO
State	CA
ZIP	91340
Phone	818 627-3050
CertificateType	3
CertificateEffectiveDate	6/17/2023
CertificateExpirationDate	6/16/2025
FacilityType	PPMP

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