05D0680379 CLIA NUMBER - DOCTORS URGENT CARE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0680379
  • Facility Name: DOCTORS URGENT CARE MEDICAL GROUP
  • Facility Address: 120 S MONTEBELLO BLVD
    MONTEBELLO, CA
    ZIP 90640
  • Facility Phone: 323 726-0533
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ATEF L. YACOUB MD
  • NPI Number: 1477698512
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0680379
LAB Type Physician Office
Facility Name DOCTORS URGENT CARE MEDICAL GROUP
Street 120 S MONTEBELLO BLVD
City MONTEBELLO
State CA
ZIP 90640
Phone 323 726-0533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2025
Certificate Expiration Date 9/6/2027
Facility Type Physician Office
Lab Director ATEF L. YACOUB MD

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This page was last updated on: 9/29/2025