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05D2184621 CLIA NUMBER - EDITH A JONES-POLAND MD PRIMARY CARE

Laboratory Demographics

CLIA Number: 05D2184621

Facility Name: EDITH A JONES-POLAND MD PRIMARY CARE

Facility Address:
73345 HIGHWAY 111, STE 101
PALM DESERT, CA
ZIP 92260
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Facility Phone Number: 760 773-4948

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1740283084

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 05D2184621
LAB Type Physician Office
Facility Name EDITH A JONES-POLAND MD PRIMARY CARE
Street 73345 HIGHWAY 111, STE 101
City PALM DESERT
State CA
ZIP 92260
Phone 760 773-4948
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