05D2306904 CLIA NUMBER - YUCCA VALLEY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D2306904
  • Facility Name: YUCCA VALLEY MEDICAL CLINIC
  • Facility Address: 57370 29 PALMS HWY STE 203
    YUCCA VALLEY, CA
    ZIP 92284
  • Facility Phone: 760 369-0069
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUAN M. ACOSTA
  • NPI Number: 1679690614
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 05D2306904
LAB Type Physician Office
Facility Name YUCCA VALLEY MEDICAL CLINIC
Street 57370 29 PALMS HWY STE 203
City YUCCA VALLEY
State CA
ZIP 92284
Phone 760 369-0069
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2024
Certificate Expiration Date 6/25/2026
Facility Type Physician Office
Lab Director JUAN M. ACOSTA

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