05D2057513 CLIA NUMBER - KOHL'S WELLNESS CENTER - SAN BERNARDINO

Laboratory Demographics

  • CLIA Code: 05D2057513
  • Facility Name: KOHL'S WELLNESS CENTER - SAN BERNARDINO
  • Facility Address: 825 E. CENTRAL AVE. ATTN: CHERYL FLANAGAN MISSION PT. HP
    SAN BERNARDINO, CA
    ZIP 92408
  • Facility Phone: 414 566-8452
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. HUMBERTO BARRAGAN

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CLIA Record

Field Name Field Value
CLIA Number 05D2057513
LAB Type Physician Office
Facility Name KOHL'S WELLNESS CENTER - SAN BERNARDINO
Street 825 E. CENTRAL AVE. ATTN: CHERYL FLANAGAN MISSION PT. HP
City SAN BERNARDINO
State CA
ZIP 92408
Phone 414 566-8452
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director DR. HUMBERTO BARRAGAN

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This page was last updated on: 6/4/2025