05D2185992 CLIA NUMBER - SONRISAS LATINAS MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D2185992

Facility Name: SONRISAS LATINAS MEDICAL GROUP

Facility Address:
8648 WOODMAN AVENUE #106
ARLETA, CA
ZIP 91331
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Facility Phone Number: 818 830-2866

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164041331

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	05D2185992
LAB Type	Physician Office
Facility Name	SONRISAS LATINAS MEDICAL GROUP
Street	8648 WOODMAN AVENUE #106
City	ARLETA
State	CA
ZIP	91331
Phone	818 830-2866
CertificateType	4
CertificateEffectiveDate	6/11/2022
CertificateExpirationDate	6/10/2024
FacilityType	Waiver

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