05D0943479 CLIA NUMBER - PAVILION FAMILY PHYSICIANS

Laboratory Demographics

CLIA Number: 05D0943479

Facility Name: PAVILION FAMILY PHYSICIANS

Facility Address:
1140 WEST LA VETA SUITE 700
ORANGE, CA
ZIP 92868
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Facility Phone Number: 714 547-5404

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528151511

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0943479
LAB Type	Physician Office
Facility Name	PAVILION FAMILY PHYSICIANS
Street	1140 WEST LA VETA SUITE 700
City	ORANGE
State	CA
ZIP	92868
Phone	714 547-5404
CertificateType	4
CertificateEffectiveDate	3/27/2024
CertificateExpirationDate	3/26/2026
FacilityType	Waiver

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