05D2057462 CLIA NUMBER - MEDICINA FAMILIAR

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Laboratory Demographics

CLIA Number: 05D2057462

Facility Name: MEDICINA FAMILIAR

Facility Address:
20440 SHERMAN WAY
CANOGA PARK, CA
ZIP 91306
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Facility Phone Number: 818 346-2395

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437495462

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	05D2057462
LAB Type	Physician Office
Facility Name	MEDICINA FAMILIAR
Street	20440 SHERMAN WAY
City	CANOGA PARK
State	CA
ZIP	91306
Phone	818 346-2395
CertificateType	4
CertificateEffectiveDate	1/7/2024
CertificateExpirationDate	1/6/2026
FacilityType	Waiver

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