05D2184546 CLIA NUMBER - OXNARD MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D2184546

Facility Name: OXNARD MEDICAL GROUP INC

Facility Address:
12511 OXNARD ST
N HOLLYWOOD, CA
ZIP 91606
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Facility Phone Number: 818 762-2084

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1104487776

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	05D2184546
LAB Type	Physician Office
Facility Name	OXNARD MEDICAL GROUP INC
Street	12511 OXNARD ST
City	N HOLLYWOOD
State	CA
ZIP	91606
Phone	818 762-2084
CertificateType	4
CertificateEffectiveDate	5/21/2022
CertificateExpirationDate	5/20/2024
FacilityType	Waiver

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