05D0969906 CLIA NUMBER - SRIVIDYA VENKATARAMAN MD INC

Laboratory Demographics

CLIA Number: 05D0969906

Facility Name: SRIVIDYA VENKATARAMAN MD INC

Facility Address:
3816 WOODRUFF AVENUE, #407
LONG BEACH, CA
ZIP 90808
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Facility Phone Number: 562 497-9314

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1063522217

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	05D0969906
LAB Type	Hospital
Facility Name	SRIVIDYA VENKATARAMAN MD INC
Street	3816 WOODRUFF AVENUE, #407
City	LONG BEACH
State	CA
ZIP	90808
Phone	562 497-9314
CertificateType	4
CertificateEffectiveDate	1/31/2024
CertificateExpirationDate	1/30/2026
FacilityType	Waiver

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