05D1089505 CLIA NUMBER - DIGNITY HEALTH MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D1089505
  • Facility Name: DIGNITY HEALTH MEDICAL GROUP
  • Facility Address: 1700 N ROSE AVE STE 210
    OXNARD, CA
    ZIP 93030
  • Facility Phone: 916 379-2861
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KOJI KUBO
  • NPI Number: 1073665360
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 05D1089505
LAB Type Physician Office
Facility Name DIGNITY HEALTH MEDICAL GROUP
Street 1700 N ROSE AVE STE 210
City OXNARD
State CA
ZIP 93030
Phone 916 379-2861
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director KOJI KUBO

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