05D0983914 CLIA NUMBER - SANTO NINO MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 05D0983914

Facility Name: SANTO NINO MEDICAL CLINIC

Facility Address:
14427 CHASE ST, STE 100
PANORAMA CITY, CA
ZIP 91402
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Facility Phone Number: 818 830-7751

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1770685612

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	05D0983914
LAB Type	Community Clinic
Facility Name	SANTO NINO MEDICAL CLINIC
Street	14427 CHASE ST, STE 100
City	PANORAMA CITY
State	CA
ZIP	91402
Phone	818 830-7751
CertificateType	4
CertificateEffectiveDate	3/8/2023
CertificateExpirationDate	3/7/2025
FacilityType	Waiver

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