05D0579910 CLIA NUMBER - ST JOSEPH HERITAGE HEALTHCARE

Laboratory Demographics

CLIA Number: 05D0579910

Facility Name: ST JOSEPH HERITAGE HEALTHCARE

Facility Address:
1010 W LA VETA AVE STE 200
ORANGE, CA
ZIP 92868
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Facility Phone Number: (714) 835-1800

Facility Type: PHYSICIAN OFFICE

Certificate Type: Certificate of Compliance

NPI Number: 1801443510

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name Field Value
CLIA Number 05D0579910
LAB Type PHYSICIAN OFFICE
Facility Name ST JOSEPH HERITAGE HEALTHCARE
Street 1010 W LA VETA AVE STE 200
City ORANGE
State CA
ZIP 92868
Phone (714) 835-1800

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