05D0712088 CLIA NUMBER - FRED GALLUCCIO MD & ASSOC INC

Laboratory Demographics

  • CLIA Code: 05D0712088
  • Facility Name: FRED GALLUCCIO MD & ASSOC INC
  • Facility Address: 901 DOVER DRIVE SUITE 102
    NEWPORT BEACH, CA
    ZIP 92660
  • Facility Phone: 949 646-4865
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: FRED J. GALLUCCIO
  • NPI Number: 1104934397
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

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
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 FRED J. GALLUCCIO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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