05D0913911 CLIA NUMBER - JESSICA BASA MD INC DBA BARSTOW FAMILY CARE

Laboratory Demographics

  • CLIA Code: 05D0913911
  • Facility Name: JESSICA BASA MD INC DBA BARSTOW FAMILY CARE
  • Facility Address: 705 E VIRGINIA WAY STE F
    BARSTOW, CA
    ZIP 92311
  • Facility Phone: 760 256-1226
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA V. BASA
  • NPI Number: 1952360539
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0913911
LAB Type Physician Office
Facility Name JESSICA BASA MD INC DBA BARSTOW FAMILY CARE
Street 705 E VIRGINIA WAY STE F
City BARSTOW
State CA
ZIP 92311
Phone 760 256-1226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Physician Office
Lab Director JESSICA V. BASA

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