05D2011858 CLIA NUMBER - ALBION MEDICAL PARTNERS OF CALIFORNIA WEST, PC

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Laboratory Demographics

CLIA Number: 05D2011858

Facility Name: ALBION MEDICAL PARTNERS OF CALIFORNIA WEST, PC

Facility Address:
19059 BEAR VALLEY RD
APPLE VALLEY, CA
ZIP 92308
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Facility Phone Number: 760 515-5000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1639542194

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	05D2011858
LAB Type	Physician Office
Facility Name	ALBION MEDICAL PARTNERS OF CALIFORNIA WEST, PC
Street	19059 BEAR VALLEY RD
City	APPLE VALLEY
State	CA
ZIP	92308
Phone	760 515-5000
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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