05D2070465 CLIA NUMBER - CENTRAL VALLEY CARDIOVASCULAR MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D2070465
  • Facility Name: CENTRAL VALLEY CARDIOVASCULAR MEDICAL GROUP
  • Facility Address: 600 W I ST STE A
    LOS BANOS, CA
    ZIP 93635
  • Facility Phone: 209 826-4800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YOHANNES GEBREEQZIABHER, MD
  • NPI Number: 1457500456
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 05D2070465
LAB Type Physician Office
Facility Name CENTRAL VALLEY CARDIOVASCULAR MEDICAL GROUP
Street 600 W I ST STE A
City LOS BANOS
State CA
ZIP 93635
Phone 209 826-4800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Physician Office
Lab Director YOHANNES GEBREEQZIABHER, MD

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This page was last updated on: 9/29/2025