05D1055254 CLIA NUMBER - PAJARO VALLEY MEDICAL CLINIC, INC

Laboratory Demographics

CLIA Number: 05D1055254

Facility Name: PAJARO VALLEY MEDICAL CLINIC, INC

Facility Address:
65 NIELSON STREET, STE 104
WATSONVILLE, CA
ZIP 95076
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Facility Phone Number: 831 786-8595

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1679509798

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	05D1055254
LAB Type	Physician Office
Facility Name	PAJARO VALLEY MEDICAL CLINIC, INC
Street	65 NIELSON STREET, STE 104
City	WATSONVILLE
State	CA
ZIP	95076
Phone	831 786-8595
CertificateType	3
CertificateEffectiveDate	6/13/2022
CertificateExpirationDate	6/12/2024
FacilityType	PPMP

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