05D2315876 CLIA NUMBER - CLINICA MEDICA PACOIMA

Laboratory Demographics

  • CLIA Code: 05D2315876
  • Facility Name: CLINICA MEDICA PACOIMA
  • Facility Address: 13630 VAN NUYS BLVD STE 107
    PACOIMA, CA
    ZIP 91331
  • Facility Phone: 747 777-6099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEFAN RUEHM
  • NPI Number: 1649038985
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2315876
LAB Type Physician Office
Facility Name CLINICA MEDICA PACOIMA
Street 13630 VAN NUYS BLVD STE 107
City PACOIMA
State CA
ZIP 91331
Phone 747 777-6099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Physician Office
Lab Director STEFAN RUEHM

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