05D0969751 CLIA NUMBER - HEALTH ON WHEELS C/O NORWALK-LA MIRADA UNIFED SCHOOL DISTRICT

Laboratory Demographics

CLIA Number: 05D0969751

Facility Name: HEALTH ON WHEELS C/O NORWALK-LA MIRADA UNIFED SCHOOL DISTRICT

Facility Address:
12820 PIONEER BLVD
NORWALK, CA
ZIP 90650
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Facility Phone Number: 562 921-7981

Facility Type: Other - SCHOOL BASED CLINIC

Certificate Type: Waiver

NPI Number: 1033321187

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0969751
LAB Type	Other - SCHOOL BASED CLINIC
Facility Name	HEALTH ON WHEELS C/O NORWALK-LA MIRADA UNIFED SCHOOL DISTRICT
Street	12820 PIONEER BLVD
City	NORWALK
State	CA
ZIP	90650
Phone	562 921-7981
CertificateType	4
CertificateEffectiveDate	1/25/2024
CertificateExpirationDate	1/24/2026
FacilityType	Waiver

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