05D1012721 CLIA NUMBER - ANTELOPE VALLEY ENDOCRINOLOGY, A PROFESSIONAL MEDICAL CORPORATION

Laboratory Demographics

CLIA Number: 05D1012721

Facility Name: ANTELOPE VALLEY ENDOCRINOLOGY, A PROFESSIONAL MEDICAL CORPORATION

Facility Address:
43723 20TH ST W STE 204
LANCASTER, CA
ZIP 93534
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Facility Phone Number: 661 949-8882

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1801940812

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	05D1012721
LAB Type	Physician Office
Facility Name	ANTELOPE VALLEY ENDOCRINOLOGY, A PROFESSIONAL MEDICAL CORPORATION
Street	43723 20TH ST W STE 204
City	LANCASTER
State	CA
ZIP	93534
Phone	661 949-8882
CertificateType	4
CertificateEffectiveDate	5/19/2023
CertificateExpirationDate	5/18/2025
FacilityType	Waiver

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