05D0971727 CLIA NUMBER - WESTSIDE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0971727
  • Facility Name: WESTSIDE MEDICAL GROUP
  • Facility Address: 1107 O STREET
    FIREBAUGH, CA
    ZIP 93622
  • Facility Phone: 559 659-9000
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DENNIS K. MILLER
  • NPI Number: 1568657351
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 05D0971727
LAB Type Rural Health Clinic
Facility Name WESTSIDE MEDICAL GROUP
Street 1107 O STREET
City FIREBAUGH
State CA
ZIP 93622
Phone 559 659-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Rural Health Clinic
Lab Director DENNIS K. MILLER

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This page was last updated on: 9/29/2025