05D2164129 CLIA NUMBER - KERN RADIOLOGY MEDICAL GROUP, INC

Laboratory Demographics

CLIA Number: 05D2164129

Facility Name: KERN RADIOLOGY MEDICAL GROUP, INC

Facility Address:
3838 SAN DIAMS STREET, A-120
BAKERSFIELD, CA
ZIP 93301
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Facility Phone Number: 661 326-9600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790109130

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	05D2164129
LAB Type	Physician Office
Facility Name	KERN RADIOLOGY MEDICAL GROUP, INC
Street	3838 SAN DIAMS STREET, A-120
City	BAKERSFIELD
State	CA
ZIP	93301
Phone	661 326-9600
CertificateType	4
CertificateEffectiveDate	3/28/2023
CertificateExpirationDate	3/27/2025
FacilityType	Waiver

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