05D0926615 CLIA NUMBER - JOSE D BERGANZA MD INC

Laboratory Demographics

  • CLIA Code: 05D0926615
  • Facility Name: JOSE D BERGANZA MD INC
  • Facility Address: 14514 RAMONA BOULEVARD SUITE 3
    BALDWIN PARK, CA
    ZIP 91706
  • Facility Phone: 626 337-0424
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE D. BERGANZA MD
  • NPI Number: 1003997032
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0926615
LAB Type Physician Office
Facility Name JOSE D BERGANZA MD INC
Street 14514 RAMONA BOULEVARD SUITE 3
City BALDWIN PARK
State CA
ZIP 91706
Phone 626 337-0424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director JOSE D. BERGANZA MD

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