05D0581602 CLIA NUMBER - AMERICAN FAMILY MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D0581602

Facility Name: AMERICAN FAMILY MEDICAL GROUP INC

Facility Address:
2414 S FAIRVIEW ST STE 112
SANTA ANA, CA
ZIP 92704
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Facility Phone Number: 714 641-0121

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1750410007

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0581602
LAB Type	Physician Office
Facility Name	AMERICAN FAMILY MEDICAL GROUP INC
Street	2414 S FAIRVIEW ST STE 112
City	SANTA ANA
State	CA
ZIP	92704
Phone	714 641-0121
CertificateType	3
CertificateEffectiveDate	12/11/2022
CertificateExpirationDate	12/10/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024