05D0554416 CLIA NUMBER - MEMORIAL CARE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0554416
  • Facility Name: MEMORIAL CARE MEDICAL GROUP
  • Facility Address: 450 E SPRING ST SUITE #1
    LONG BEACH, CA
    ZIP 90806
  • Facility Phone: 562 933-0050
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ABIGAIL FLETCHER
  • NPI Number: 1760600621
  • Taxonomy: 213ES0131X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 05D0554416
LAB Type Physician Office
Facility Name MEMORIAL CARE MEDICAL GROUP
Street 450 E SPRING ST SUITE #1
City LONG BEACH
State CA
ZIP 90806
Phone 562 933-0050
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 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director ABIGAIL FLETCHER

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This page was last updated on: 3/20/2025