HERITAGE VICTOR VALLEY MEDICAL GROUP
NPI 1295126001
Clinic/Center in Victorville, CA
About Heritage Victor Valley Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HERITAGE VICTOR VALLEY MEDICAL GROUP (NPI 1295126001) is a healthcare organization registered as a clinic/center in Victorville, California and active in the NPI registry since February 2015. The organization holds a CLIA Waiver certificate valid through September 28, 2027, maintains 5 additional practice locations, and lists Martha Paredes, Billing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 7
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Other Names 1
Secondary Practice Locations 5
Group Practice 1
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2030527
- Facility Type
- Physician Office
- Certificate Effective Date
- September 29, 2025
- Certificate Expiration Date
- September 28, 2027
- Laboratory Director
- PRAKASH YAKKUNDI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Heritage Victor Valley Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Other Providers at the Same Location
The following 14 providers are registered at the same or a nearby location.
VICTORVILLE, CA 92395
VICTORVILLE, CA 92395
VICTORVILLE, CA 92395
VICTORVILLE, CA 92395
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295126001, enumerated as an "organization" on February 16, 2015.
The provider is located at 12370 HESPERIA RD SUITE 6 VICTORVILLE, CA 92395 and the phone number is (760) 245-4747.
Clinic/Center with taxonomy code 261Q00000X.
