05D2310756 CLIA NUMBER - AMELIE WAGNER MD

Laboratory Demographics

  • CLIA Code: 05D2310756
  • Facility Name: AMELIE WAGNER MD
  • Facility Address: 40700 CALIFORNIA OAKS RD STE 208
    MURRIETA, CA
    ZIP 92562
  • Facility Phone: 408 757-0730
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMELIE WAGNER
  • NPI Number: 1912772336
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2310756
LAB Type Physician Office
Facility Name AMELIE WAGNER MD
Street 40700 CALIFORNIA OAKS RD STE 208
City MURRIETA
State CA
ZIP 92562
Phone 408 757-0730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Physician Office
Lab Director AMELIE WAGNER

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