05D0552364 CLIA NUMBER - PIH HEALTH PHYSICIANS

Laboratory Demographics

  • CLIA Code: 05D0552364
  • Facility Name: PIH HEALTH PHYSICIANS
  • Facility Address: 12400 BLOOMFIELD AVE
    SANTA FE SPRINGS, CA
    ZIP 90670
  • Facility Phone: 562 789-5434
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: USAMA S. MITRY MD
  • NPI Number: 1598919235
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0552364
LAB Type Physician Office
Facility Name PIH HEALTH PHYSICIANS
Street 12400 BLOOMFIELD AVE
City SANTA FE SPRINGS
State CA
ZIP 90670
Phone 562 789-5434
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 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Physician Office
Lab Director USAMA S. MITRY MD

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