05D2132233 CLIA NUMBER - VENTURA ORTHOPEDIC MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D2132233

Facility Name: VENTURA ORTHOPEDIC MEDICAL GROUP

Facility Address:
2525 ERRINGER RD
SIMI VALLEY, CA
ZIP 93065
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Facility Phone Number: 805 527-1404

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1629531454

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D2132233
LAB Type	Physician Office
Facility Name	VENTURA ORTHOPEDIC MEDICAL GROUP
Street	2525 ERRINGER RD
City	SIMI VALLEY
State	CA
ZIP	93065
Phone	805 527-1404
CertificateType	4
CertificateEffectiveDate	6/14/2023
CertificateExpirationDate	6/13/2025
FacilityType	Waiver

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