05D1093154 CLIA NUMBER - DERAKHSH FOZOUNI, MD OB/GYN & ASSOCIATES, AMC

Laboratory Demographics

CLIA Number: 05D1093154

Facility Name: DERAKHSH FOZOUNI, MD OB/GYN & ASSOCIATES, AMC

Facility Address:
555 TACHEVAH DR STE 2W-103
PALM SPRINGS, CA
ZIP 92262
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Facility Phone Number: 760 327-2707

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1255587630

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	05D1093154
LAB Type	Physician Office
Facility Name	DERAKHSH FOZOUNI, MD OB/GYN & ASSOCIATES, AMC
Street	555 TACHEVAH DR STE 2W-103
City	PALM SPRINGS
State	CA
ZIP	92262
Phone	760 327-2707
CertificateType	4
CertificateEffectiveDate	12/11/2022
CertificateExpirationDate	12/10/2024
FacilityType	Waiver

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