05D2306713 CLIA NUMBER - PTASHINSKY MEDICAL DBA STRAWBERRY CREEK MEDICAL

Laboratory Demographics

  • CLIA Code: 05D2306713
  • Facility Name: PTASHINSKY MEDICAL DBA STRAWBERRY CREEK MEDICAL
  • Facility Address: 54910 N CIRCLE DR
    IDYLLWILD, CA
    ZIP 92549
  • Facility Phone: 951 527-0008
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: ALEXANDER J. CHARMOZ
  • NPI Number: 1891424644
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2306713
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PTASHINSKY MEDICAL DBA STRAWBERRY CREEK MEDICAL
Street 54910 N CIRCLE DR
City IDYLLWILD
State CA
ZIP 92549
Phone 951 527-0008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director ALEXANDER J. CHARMOZ

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