05D0577405 CLIA NUMBER - NEWPORT CHILDREN'S MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D0577405

Facility Name: NEWPORT CHILDREN'S MEDICAL GROUP

Facility Address:
3151 AIRWAY AVE UNIT C2
COSTA MESA, CA
ZIP 92626
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Facility Phone Number: (714) 698-1648

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

CLIA Record

Field Name	Field Value
CLIA Number	05D0577405
LAB Type	PHYSICIAN OFFICE
Facility Name	NEWPORT CHILDREN'S MEDICAL GROUP
Street	3151 AIRWAY AVE UNIT C2
City	COSTA MESA
State	CA
ZIP	92626
Phone	(714) 698-1648

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