05D1101722 CLIA NUMBER - SANJIV GOEL, MD

Laboratory Demographics

CLIA Number: 05D1101722

Facility Name: SANJIV GOEL, MD

Facility Address:
2100 LYNN ROAD, SUITE 205
THOUSAND OAKS, CA
ZIP 91360
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Facility Phone Number: 805 497-3585

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1700983707

Taxonomy: 207RI0011X - Internal Medicine
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

CLIA Record

Field Name	Field Value
CLIA Number	05D1101722
LAB Type	Physician Office
Facility Name	SANJIV GOEL, MD
Street	2100 LYNN ROAD, SUITE 205
City	THOUSAND OAKS
State	CA
ZIP	91360
Phone	805 497-3585
CertificateType	4
CertificateEffectiveDate	7/2/2023
CertificateExpirationDate	7/1/2025
FacilityType	Waiver

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