05D0551572 CLIA NUMBER - SANDRA MADRID MD WASH-WHITTIER MED BLD

Laboratory Demographics

  • CLIA Code: 05D0551572
  • Facility Name: SANDRA MADRID MD WASH-WHITTIER MED BLD
  • Facility Address: 12462 E WASHINGTON BLVD
    WHITTIER, CA
    ZIP 90602
  • Facility Phone: 562 693-0725
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SANDRA MADRID
  • NPI Number: 1770594640
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0551572
LAB Type Physician Office
Facility Name SANDRA MADRID MD WASH-WHITTIER MED BLD
Street 12462 E WASHINGTON BLVD
City WHITTIER
State CA
ZIP 90602
Phone 562 693-0725
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director SANDRA MADRID

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