05D2108302 CLIA NUMBER - VISTA DEL MAR MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D2108302

Facility Name: VISTA DEL MAR MEDICAL GROUP INC

Facility Address:
2412 PONDEROSA DR NORTH STE B-100
CAMARILLO, CA
ZIP 93010
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Facility Phone Number: (805) 983-0691

Facility Type: PHYSICIAN OFFICE

Certificate Type: Microscopy

NPI Number: 1942239694

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	05D2108302
LAB Type	PHYSICIAN OFFICE
Facility Name	VISTA DEL MAR MEDICAL GROUP INC
Street	2412 PONDEROSA DR NORTH STE B-100
City	CAMARILLO
State	CA
ZIP	93010
Phone	(805) 983-0691

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