05D0581357 CLIA NUMBER - INTEGRATIVE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 05D0581357
  • Facility Name: INTEGRATIVE MEDICAL CENTER
  • Facility Address: 526 W 17TH
    SANTA ANA, CA
    ZIP 92706
  • Facility Phone: 714 558-9355
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WALTER JAYASINGHE MD
  • NPI Number: 1609017805
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0581357
LAB Type Physician Office
Facility Name INTEGRATIVE MEDICAL CENTER
Street 526 W 17TH
City SANTA ANA
State CA
ZIP 92706
Phone 714 558-9355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Physician Office
Lab Director WALTER JAYASINGHE MD

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