05D0576616 CLIA NUMBER - ST JUDE HERITAGE DERMATOLOGY LAB #1

Laboratory Demographics

CLIA Number: 05D0576616

Facility Name: ST JUDE HERITAGE DERMATOLOGY LAB #1

Facility Address:
955 W IMPERIAL HWY, STE 200
BREA, CA
ZIP 92821
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Facility Phone Number: (714) 257-6133

Facility Type: PHYSICIAN OFFICE

Certificate Type: Certificate of Compliance

CLIA Record

Field Name Field Value
CLIA Number 05D0576616
LAB Type PHYSICIAN OFFICE
Facility Name ST JUDE HERITAGE DERMATOLOGY LAB #1
Street 955 W IMPERIAL HWY, STE 200
City BREA
State CA
ZIP 92821
Phone (714) 257-6133

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This page was last updated on: 1/7/2022