05D0581820 CLIA NUMBER - MEMORIALCARE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0581820
  • Facility Name: MEMORIALCARE MEDICAL GROUP
  • Facility Address: 4050 BARRANCA PKWY, SUITE 200
    IRVINE, CA
    ZIP 92604
  • Facility Phone: 949 551-1090
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANTHONY WONG
  • NPI Number: 1215079298
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 05D0581820
LAB Type Physician Office
Facility Name MEMORIALCARE MEDICAL GROUP
Street 4050 BARRANCA PKWY, SUITE 200
City IRVINE
State CA
ZIP 92604
Phone 949 551-1090
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 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director ANTHONY WONG

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This page was last updated on: 6/4/2025