05D0577405 CLIA NUMBER - NEWPORT CHILDREN'S MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0577405
  • Facility Name: NEWPORT CHILDREN'S MEDICAL GROUP
  • Facility Address: 3151 AIRWAY AVE UNIT C2
    COSTA MESA, CA
    ZIP 92626
  • Facility Phone: 714 698-1648
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ZACHARIA REDA, MD

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director ZACHARIA REDA, MD

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This page was last updated on: 6/4/2025