05D0577159 CLIA NUMBER - ORANGE COUNTY RENAL MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D0577159

Facility Name: ORANGE COUNTY RENAL MEDICAL GROUP INC

Facility Address:
12665 GARDEN GROVE BLVD 211
GARDEN GROVE, CA
ZIP 92843
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Facility Phone Number: (714) 636-2890

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1407058860

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	05D0577159
LAB Type	PHYSICIAN OFFICE
Facility Name	ORANGE COUNTY RENAL MEDICAL GROUP INC
Street	12665 GARDEN GROVE BLVD 211
City	GARDEN GROVE
State	CA
ZIP	92843
Phone	(714) 636-2890

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This page was last updated on: 5/11/2023