05D1086245 CLIA NUMBER - PMK MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D1086245

Facility Name: PMK MEDICAL GROUP INC

Facility Address:
500 PASEO CAMARILLO STE 106
CAMARILLO, CA
ZIP 93010
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Facility Phone Number: 805 485-8709

Facility Type: Practitioner Other

Certificate Type: Accreditation

NPI Number: 1962405860

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	05D1086245
LAB Type	Practitioner Other
Facility Name	PMK MEDICAL GROUP INC
Street	500 PASEO CAMARILLO STE 106
City	CAMARILLO
State	CA
ZIP	93010
Phone	805 485-8709
CertificateType	1
CertificateEffectiveDate	9/4/2023
CertificateExpirationDate	9/3/2025
FacilityType	Accreditation

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