05D2260671 CLIA NUMBER - CALIFORNIA HIGHWAY PATROL-MOORPARK AREA

Laboratory Demographics

CLIA Number: 05D2260671

Facility Name: CALIFORNIA HIGHWAY PATROL-MOORPARK AREA

Facility Address:
610 SPRING ROAD
MOORPARK, CA
ZIP 93021
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Facility Phone Number: 844 352-6567

Facility Type: Other - GOVERNMENT EMPLOYMENT

Certificate Type: Waiver

NPI Number: 1760586705

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	05D2260671
LAB Type	Other - GOVERNMENT EMPLOYMENT
Facility Name	CALIFORNIA HIGHWAY PATROL-MOORPARK AREA
Street	610 SPRING ROAD
City	MOORPARK
State	CA
ZIP	93021
Phone	844 352-6567
CertificateType	4
CertificateEffectiveDate	5/23/2022
CertificateExpirationDate	5/22/2024
FacilityType	Waiver

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