05D1088382 CLIA NUMBER - JAIME GONZALEZ, MD

Laboratory Demographics

CLIA Number: 05D1088382

Facility Name: JAIME GONZALEZ, MD

Facility Address:
350 VINTON AVE STE 204
POMONA, CA
ZIP 91767
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Facility Phone Number: 909 622-3353

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235180563

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D1088382
LAB Type	Physician Office
Facility Name	JAIME GONZALEZ, MD
Street	350 VINTON AVE STE 204
City	POMONA
State	CA
ZIP	91767
Phone	909 622-3353
CertificateType	4
CertificateEffectiveDate	8/25/2022
CertificateExpirationDate	8/24/2024
FacilityType	Waiver

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