05D0554369 CLIA NUMBER - COLUMBIA PEDIATRICS MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0554369
  • Facility Name: COLUMBIA PEDIATRICS MEDICAL GROUP INC
  • Facility Address: 3833 WORSHAM AVE STE 301
    LONG BEACH, CA
    ZIP 90808
  • Facility Phone: 562 595-5479
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDDIE P. QUAN
  • NPI Number: 1982777876
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0554369
LAB Type Physician Office
Facility Name COLUMBIA PEDIATRICS MEDICAL GROUP INC
Street 3833 WORSHAM AVE STE 301
City LONG BEACH
State CA
ZIP 90808
Phone 562 595-5479
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2024
Certificate Expiration Date 4/3/2026
Facility Type Physician Office
Lab Director EDDIE P. QUAN

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