05D0552098 CLIA NUMBER - LA MIRADA FAMILY MED GRP

Laboratory Demographics

  • CLIA Code: 05D0552098
  • Facility Name: LA MIRADA FAMILY MED GRP
  • Facility Address: 15651 E IMPERIAL HWY
    LA MIRADA, CA
    ZIP 90638
  • Facility Phone: 562 943-6761
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL L. KWOK MD
  • NPI Number: 1982227823
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 05D0552098
LAB Type Physician Office
Facility Name LA MIRADA FAMILY MED GRP
Street 15651 E IMPERIAL HWY
City LA MIRADA
State CA
ZIP 90638
Phone 562 943-6761
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 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director MICHAEL L. KWOK MD

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