05D0712088 CLIA NUMBER - FRED GALLUCCIO MD & ASSOC INC

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Laboratory Demographics

CLIA Number: 05D0712088

Facility Name: FRED GALLUCCIO MD & ASSOC INC

Facility Address:
901 DOVER DRIVE SUITE 102
NEWPORT BEACH, CA
ZIP 92660
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Facility Phone Number: 949 646-4865

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1104934397

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0712088
LAB Type	Physician Office
Facility Name	FRED GALLUCCIO MD & ASSOC INC
Street	901 DOVER DRIVE SUITE 102
City	NEWPORT BEACH
State	CA
ZIP	92660
Phone	949 646-4865
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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