05D2115474 CLIA NUMBER - SYLMAR CLINICA MEDICASYLMAR URGENT CARE

Laboratory Demographics

CLIA Number: 05D2115474

Facility Name: SYLMAR CLINICA MEDICASYLMAR URGENT CARE

Facility Address:
13711 FOOTHILL BLVD UNIT B
SYLMAR, CA
ZIP 91342
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Facility Phone Number: 818 408-8008

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902269251

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	05D2115474
LAB Type	Physician Office
Facility Name	SYLMAR CLINICA MEDICASYLMAR URGENT CARE
Street	13711 FOOTHILL BLVD UNIT B
City	SYLMAR
State	CA
ZIP	91342
Phone	818 408-8008
CertificateType	4
CertificateEffectiveDate	7/7/2022
CertificateExpirationDate	7/6/2024
FacilityType	Waiver

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