05D0983476 CLIA NUMBER - LA SALLE MEDICAL ASSOCIATES

Laboratory Demographics

CLIA Number: 05D0983476

Facility Name: LA SALLE MEDICAL ASSOCIATES

Facility Address:
565 N MT VERNON AVE
SAN BERNARDINO, CA
ZIP 92411
Get Directions

Facility Phone Number: 909 884-9091

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1447388251

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0983476
LAB Type	Physician Office
Facility Name	LA SALLE MEDICAL ASSOCIATES
Street	565 N MT VERNON AVE
City	SAN BERNARDINO
State	CA
ZIP	92411
Phone	909 884-9091
CertificateType	4
CertificateEffectiveDate	2/23/2023
CertificateExpirationDate	2/22/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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