05D0713358 CLIA NUMBER - WELLCARE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0713358
  • Facility Name: WELLCARE MEDICAL GROUP
  • Facility Address: 16415 S COLORADO AVE SUITE 208
    PARAMOUNT, CA
    ZIP 90723
  • Facility Phone: 562 531-0015
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD W. LEE
  • NPI Number: 1225314107
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0713358
LAB Type Physician Office
Facility Name WELLCARE MEDICAL GROUP
Street 16415 S COLORADO AVE SUITE 208
City PARAMOUNT
State CA
ZIP 90723
Phone 562 531-0015
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 RICHARD W. LEE

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