05D0963842 CLIA NUMBER - BUELLTON MEDICAL CENTER A MEDICAL CORPORATION

Laboratory Demographics

CLIA Number: 05D0963842

Facility Name: BUELLTON MEDICAL CENTER A MEDICAL CORPORATION

Facility Address:
195 W HIGHWAY 246
BUELLTON, CA
ZIP 93427
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Facility Phone Number: 805 686-8555

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558531053

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	05D0963842
LAB Type	Physician Office
Facility Name	BUELLTON MEDICAL CENTER A MEDICAL CORPORATION
Street	195 W HIGHWAY 246
City	BUELLTON
State	CA
ZIP	93427
Phone	805 686-8555
CertificateType	4
CertificateEffectiveDate	8/10/2023
CertificateExpirationDate	8/9/2025
FacilityType	Waiver

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