05D2262503 CLIA NUMBER - LA VISTA HEALTH

Laboratory Demographics

CLIA Number: 05D2262503

Facility Name: LA VISTA HEALTH

Facility Address:
1111 GRAND AVE, STE L
DIAMOND BAR, CA
ZIP 91765
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Facility Phone Number: 909 551-0205

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942817804

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D2262503
LAB Type	Physician Office
Facility Name	LA VISTA HEALTH
Street	1111 GRAND AVE, STE L
City	DIAMOND BAR
State	CA
ZIP	91765
Phone	909 551-0205
CertificateType	4
CertificateEffectiveDate	6/14/2022
CertificateExpirationDate	6/13/2024
FacilityType	Waiver

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