05D2272232 CLIA NUMBER - KWB MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D2272232

Facility Name: KWB MEDICAL GROUP INC

Facility Address:
7537 LAUREL CANYON BLVD UNIT A
NORTH HOLLYWOOD, CA
ZIP 91605
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Facility Phone Number: 818 793-7195

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1366195265

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	05D2272232
LAB Type	Physician Office
Facility Name	KWB MEDICAL GROUP INC
Street	7537 LAUREL CANYON BLVD UNIT A
City	NORTH HOLLYWOOD
State	CA
ZIP	91605
Phone	818 793-7195
CertificateType	4
CertificateEffectiveDate	11/16/2022
CertificateExpirationDate	11/15/2024
FacilityType	Waiver

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