05D0580456 CLIA NUMBER - MEMORIAL CARE MEDICAL FOUNDATION

Laboratory Demographics

CLIA Number: 05D0580456

Facility Name: MEMORIAL CARE MEDICAL FOUNDATION

Facility Address:
23512 MADERO ROAD
MISSION VIEJO, CA
ZIP 92691
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Facility Phone Number: (657) 241-9062

Facility Type: PHYSICIAN OFFICE

Certificate Type: Microscopy

NPI Number: 1194866772

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	05D0580456
LAB Type	PHYSICIAN OFFICE
Facility Name	MEMORIAL CARE MEDICAL FOUNDATION
Street	23512 MADERO ROAD
City	MISSION VIEJO
State	CA
ZIP	92691
Phone	(657) 241-9062

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