05D2132234 CLIA NUMBER - VENTURA ORTHOPEDIC MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D2132234

Facility Name: VENTURA ORTHOPEDIC MEDICAL GROUP

Facility Address:
2221 WANKEL WAY
OXNARD, CA
ZIP 93030
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Facility Phone Number: 805 988-9366

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790248508

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	05D2132234
LAB Type	Physician Office
Facility Name	VENTURA ORTHOPEDIC MEDICAL GROUP
Street	2221 WANKEL WAY
City	OXNARD
State	CA
ZIP	93030
Phone	805 988-9366
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