05D2058601 CLIA NUMBER - EXER WITH PROVIDENCE

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Laboratory Demographics

CLIA Number: 05D2058601

Facility Name: EXER WITH PROVIDENCE

Facility Address:
26777 AGOURA RD STE 4 EXECUTIVE ER
CALABASAS, CA
ZIP 91302
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Facility Phone Number: (818) 880-2225

Facility Type: OTHER

Certificate Type: Certificate of Compliance

CLIA Record

Field Name	Field Value
CLIA Number	05D2058601
LAB Type	OTHER
Facility Name	EXER WITH PROVIDENCE
Street	26777 AGOURA RD STE 4 EXECUTIVE ER
City	CALABASAS
State	CA
ZIP	91302
Phone	(818) 880-2225

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This page was last updated on: 5/11/2023