05D2090911 CLIA NUMBER - JAISIMARAN KAUR SIDHU

Laboratory Demographics

  • CLIA Code: 05D2090911
  • Facility Name: JAISIMARAN KAUR SIDHU
  • Facility Address: 585 W PUTNAM AVE
    PORTERVILLE, CA
    ZIP 93257
  • Facility Phone: 559 781-1666
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAISIMARAN K. SIDHU
  • NPI Number: 1174784300
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2090911
LAB Type Physician Office
Facility Name JAISIMARAN KAUR SIDHU
Street 585 W PUTNAM AVE
City PORTERVILLE
State CA
ZIP 93257
Phone 559 781-1666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type Physician Office
Lab Director JAISIMARAN K. SIDHU

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