05D0704666 CLIA NUMBER - TERESITA E TAN MD

Laboratory Demographics

CLIA Number: 05D0704666

Facility Name: TERESITA E TAN MD

Facility Address:
OXFORD MED CLINIC 244 S OXFORD AV #9
LOS ANGELES, CA
ZIP 90004
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Facility Phone Number: 213 382-1770

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396835633

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	05D0704666
LAB Type	Physician Office
Facility Name	TERESITA E TAN MD
Street	OXFORD MED CLINIC 244 S OXFORD AV #9
City	LOS ANGELES
State	CA
ZIP	90004
Phone	213 382-1770
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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