05D0946916 CLIA NUMBER - DEAN FERDOWS, MD

Laboratory Demographics

CLIA Number: 05D0946916

Facility Name: DEAN FERDOWS, MD

Facility Address:
4316 EAST SLAUSON AVENUE
MAYWOOD, CA
ZIP 90270
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Facility Phone Number: 323 773-2020

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679587091

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	05D0946916
LAB Type	Physician Office
Facility Name	DEAN FERDOWS, MD
Street	4316 EAST SLAUSON AVENUE
City	MAYWOOD
State	CA
ZIP	90270
Phone	323 773-2020
CertificateType	4
CertificateEffectiveDate	6/4/2022
CertificateExpirationDate	6/3/2024
FacilityType	Waiver

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