05D2188998 CLIA NUMBER - COMMUNITY FOUNDATION MEDICAL GROUP- CLOVIS PEDIATRIC GROUP

Laboratory Demographics

  • CLIA Code: 05D2188998
  • Facility Name: COMMUNITY FOUNDATION MEDICAL GROUP- CLOVIS PEDIATRIC GROUP
  • Facility Address: 4910 E ASHLAN AVE STE 116
    FRESNO, CA
    ZIP 93726
  • Facility Phone: 559 228-2990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMAR SIDDIQUE
  • NPI Number: 1023180742
  • Taxonomy: 122300000X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2188998
LAB Type Physician Office
Facility Name COMMUNITY FOUNDATION MEDICAL GROUP- CLOVIS PEDIATRIC GROUP
Street 4910 E ASHLAN AVE STE 116
City FRESNO
State CA
ZIP 93726
Phone 559 228-2990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2024
Certificate Expiration Date 7/23/2026
Facility Type Physician Office
Lab Director AMAR SIDDIQUE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025