05D0926008 CLIA NUMBER - EZZAT NASHED MD.

Laboratory Demographics

  • CLIA Code: 05D0926008
  • Facility Name: EZZAT NASHED MD.
  • Facility Address: 16200 BEAR VALLEY RD STE 102
    VICTORVILLE, CA
    ZIP 92395
  • Facility Phone: 760 962-0077
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EZZAT A. MASHED
  • NPI Number: 1336106640
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0926008
LAB Type Physician Office
Facility Name EZZAT NASHED MD.
Street 16200 BEAR VALLEY RD STE 102
City VICTORVILLE
State CA
ZIP 92395
Phone 760 962-0077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Physician Office
Lab Director EZZAT A. MASHED

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