05D2025982 CLIA NUMBER - HESPERIA CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION

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Laboratory Demographics

CLIA Number: 05D2025982

Facility Name: HESPERIA CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION

Facility Address:
15888 MAIN ST STE 112(B)
HESPERIA, CA
ZIP 92345
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Facility Phone Number: 760 948-2242

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164728788

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	05D2025982
LAB Type	Physician Office
Facility Name	HESPERIA CLINICA MEDICA FAMILIAR A MEDICAL CORPORATION
Street	15888 MAIN ST STE 112(B)
City	HESPERIA
State	CA
ZIP	92345
Phone	760 948-2242
CertificateType	4
CertificateEffectiveDate	6/22/2023
CertificateExpirationDate	6/21/2025
FacilityType	Waiver

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