05D0980130 CLIA NUMBER - VERDUGO HILLS MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D0980130

Facility Name: VERDUGO HILLS MEDICAL GROUP

Facility Address:
1818 VERDUGO BLVD STE 401
GLENDALE, CA
ZIP 91208
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Facility Phone Number: 818 790-1145

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528054632

Taxonomy: 282NR1301X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	05D0980130
LAB Type	Physician Office
Facility Name	VERDUGO HILLS MEDICAL GROUP
Street	1818 VERDUGO BLVD STE 401
City	GLENDALE
State	CA
ZIP	91208
Phone	818 790-1145
CertificateType	4
CertificateEffectiveDate	11/13/2022
CertificateExpirationDate	11/12/2024
FacilityType	Waiver

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