05D1013544 CLIA NUMBER - CLINICAS DE SALUD DEL PUEBLO DBA INNERCARE

Laboratory Demographics

CLIA Number: 05D1013544

Facility Name: CLINICAS DE SALUD DEL PUEBLO DBA INNERCARE

Facility Address:
2133 WINTERHAVEN DRIVE
WINTERHAVEN, CA
ZIP 92283
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Facility Phone Number: 760 572-2700

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1124109202

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1013544
LAB Type	Other
Facility Name	CLINICAS DE SALUD DEL PUEBLO DBA INNERCARE
Street	2133 WINTERHAVEN DRIVE
City	WINTERHAVEN
State	CA
ZIP	92283
Phone	760 572-2700
CertificateType	4
CertificateEffectiveDate	6/11/2023
CertificateExpirationDate	6/10/2025
FacilityType	Waiver

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