05D0693350 CLIA NUMBER - MAGELLA MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0693350
  • Facility Name: MAGELLA MEDICAL GROUP INC
  • Facility Address: 2888 LONG BEACH BLVD STE 400
    LONG BEACH, CA
    ZIP 90806
  • Facility Phone: 310 988-0081
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL P. NAGEOTTE
  • NPI Number: 1376640086
  • Taxonomy: 207VM0101X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0693350
LAB Type Physician Office
Facility Name MAGELLA MEDICAL GROUP INC
Street 2888 LONG BEACH BLVD STE 400
City LONG BEACH
State CA
ZIP 90806
Phone 310 988-0081
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MICHAEL P. NAGEOTTE

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