05D0578420 CLIA NUMBER - HOAG CLINIC

Laboratory Demographics

  • CLIA Code: 05D0578420
  • Facility Name: HOAG CLINIC
  • Facility Address: 520 SUPERIOR AVE SUITE 360
    NEWPORT BEACH, CA
    ZIP 92663
  • Facility Phone: 949 644-7852
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JUSTIN LIAO MD
  • NPI Number: 1205040649
  • Taxonomy: 282NR1301X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 05D0578420
LAB Type Physician Office
Facility Name HOAG CLINIC
Street 520 SUPERIOR AVE SUITE 360
City NEWPORT BEACH
State CA
ZIP 92663
Phone 949 644-7852
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/10/2023
Certificate Expiration Date 8/9/2025
Facility Type Physician Office
Lab Director JUSTIN LIAO MD

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This page was last updated on: 3/20/2025