05D2292320 CLIA NUMBER - PALMDALE WOMEN'S HEALTH PHYSICIAN GROUP, INC

Laboratory Demographics

  • CLIA Code: 05D2292320
  • Facility Name: PALMDALE WOMEN'S HEALTH PHYSICIAN GROUP, INC
  • Facility Address: 41250 12TH ST W, SUITE B
    PALMDALE, CA
    ZIP 93551
  • Facility Phone: 310 901-4714
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICHOLAS A. ROGERS
  • NPI Number: 1487891420
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2292320
LAB Type Physician Office
Facility Name PALMDALE WOMEN'S HEALTH PHYSICIAN GROUP, INC
Street 41250 12TH ST W, SUITE B
City PALMDALE
State CA
ZIP 93551
Phone 310 901-4714
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Physician Office
Lab Director NICHOLAS A. ROGERS

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