05D0705228 CLIA NUMBER - JESUS LUA MD, A PROFESSIONAL MEDICAL CORP

Laboratory Demographics

  • CLIA Code: 05D0705228
  • Facility Name: JESUS LUA MD, A PROFESSIONAL MEDICAL CORP
  • Facility Address: 360 E SEVENTH ST SUITE A
    UPLAND, CA
    ZIP 91786
  • Facility Phone: 909 985-5784
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESUS LUA MD
  • NPI Number: 1992776108
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0705228
LAB Type Physician Office
Facility Name JESUS LUA MD, A PROFESSIONAL MEDICAL CORP
Street 360 E SEVENTH ST SUITE A
City UPLAND
State CA
ZIP 91786
Phone 909 985-5784
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2025
Certificate Expiration Date 7/6/2027
Facility Type Physician Office
Lab Director JESUS LUA MD

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