Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
05D2322618
|
|
Clinical laboratory number
|
|
Lab Name
|
ESPN WELLNESS CENTER
|
|
Laboratory Name
|
|
Lab Type
|
Other - OUT PATIENT
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
480-868-0646
|
|
Laboratory telephone number
|
|
Fax
|
833-985-1244
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
500 S BUENA VISA STREET
|
|
Primary location adress line
|
|
City
|
BURBANK
|
|
Primary location city name
|
|
State
|
CA
|
|
Primary location state name
|
|
Zip
|
91521
|
|
Primary location postal code
|