05D2110637 CLIA NUMBER - DAVID J HERNANDEZ, MD A PROFESSIONAL MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2110637
  • Facility Name: DAVID J HERNANDEZ, MD A PROFESSIONAL MEDICAL CORPORATION
  • Facility Address: 22119 SHERMAN WAY
    CANOGA PARK, CA
    ZIP 91303
  • Facility Phone: 747 226-3650
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID J. HERNANDEZ
  • NPI Number: 1396756912
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2110637
LAB Type Physician Office
Facility Name DAVID J HERNANDEZ, MD A PROFESSIONAL MEDICAL CORPORATION
Street 22119 SHERMAN WAY
City CANOGA PARK
State CA
ZIP 91303
Phone 747 226-3650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Physician Office
Lab Director DAVID J. HERNANDEZ

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