05D0555415 CLIA NUMBER - FOOTHILL PRIMARY CARE, INC

Laboratory Demographics

  • CLIA Code: 05D0555415
  • Facility Name: FOOTHILL PRIMARY CARE, INC
  • Facility Address: 931 BUENA VISTA STE 205
    DUARTE, CA
    ZIP 91010
  • Facility Phone: 626 358-1897
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROY L. SAENZ
  • NPI Number: 1720350259
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0555415
LAB Type Physician Office
Facility Name FOOTHILL PRIMARY CARE, INC
Street 931 BUENA VISTA STE 205
City DUARTE
State CA
ZIP 91010
Phone 626 358-1897
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2024
Certificate Expiration Date 11/9/2026
Facility Type Physician Office
Lab Director ROY L. SAENZ

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