05D1029880 CLIA NUMBER - ERIC R HANSEN DO

Laboratory Demographics

  • CLIA Code: 05D1029880
  • Facility Name: ERIC R HANSEN DO
  • Facility Address: 14575 MAIN STREET
    HESPERIA, CA
    ZIP 92345
  • Facility Phone: 760 947-0727
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIC R. HANSEN
  • NPI Number: 1770562506
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1029880
LAB Type Physician Office
Facility Name ERIC R HANSEN DO
Street 14575 MAIN STREET
City HESPERIA
State CA
ZIP 92345
Phone 760 947-0727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Physician Office
Lab Director ERIC R. HANSEN

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