05D0582203 CLIA NUMBER - ASSOCIATED GASTROENTEROLOGY MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D0582203

Facility Name: ASSOCIATED GASTROENTEROLOGY MEDICAL GROUP

Facility Address:
1211 W LA PALMA SUITE 306
ANAHEIM, CA
ZIP 92801
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Facility Phone Number: 714 778-1300

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1326044967

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0582203
LAB Type	Physician Office
Facility Name	ASSOCIATED GASTROENTEROLOGY MEDICAL GROUP
Street	1211 W LA PALMA SUITE 306
City	ANAHEIM
State	CA
ZIP	92801
Phone	714 778-1300
CertificateType	2
CertificateEffectiveDate	2/14/2023
CertificateExpirationDate	2/13/2025
FacilityType	Compliance

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