05D0991350 CLIA NUMBER - PROVIDENCE BATAVIA WOODS OB/GYN

Laboratory Demographics

  • CLIA Code: 05D0991350
  • Facility Name: PROVIDENCE BATAVIA WOODS OB/GYN
  • Facility Address: 805 W LA VETA AVE STE 101
    ORANGE, CA
    ZIP 92868
  • Facility Phone: 714 966-9795
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACADI BIGNAMI
  • NPI Number: 1710015987
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D0991350
LAB Type Physician Office
Facility Name PROVIDENCE BATAVIA WOODS OB/GYN
Street 805 W LA VETA AVE STE 101
City ORANGE
State CA
ZIP 92868
Phone 714 966-9795
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2024
Certificate Expiration Date 1/27/2026
Facility Type Physician Office
Lab Director JACADI BIGNAMI

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