05D2096180 CLIA NUMBER - HEALTH DIAGNOSTICS OF CALIFORNIA LLC DBA CENTRAL COAST DIAGNOSTIC RADIOLOGY

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Laboratory Demographics

CLIA Number: 05D2096180

Facility Name: HEALTH DIAGNOSTICS OF CALIFORNIA LLC DBA CENTRAL COAST DIAGNOSTIC RADIOLOGY

Facility Address:
665 MUNRAS AVE STE 109
MONTEREY, CA
ZIP 93940
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Facility Phone Number: 831 656-9800

Facility Type: Other - OUTPATIENT MEDICAL IMAGIN

Certificate Type: Waiver

NPI Number: 1174932701

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2096180
LAB Type	Other - OUTPATIENT MEDICAL IMAGIN
Facility Name	HEALTH DIAGNOSTICS OF CALIFORNIA LLC DBA CENTRAL COAST DIAGNOSTIC RADIOLOGY
Street	665 MUNRAS AVE STE 109
City	MONTEREY
State	CA
ZIP	93940
Phone	831 656-9800
CertificateType	4
CertificateEffectiveDate	5/18/2023
CertificateExpirationDate	5/17/2025
FacilityType	Waiver

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