05D0714884 CLIA NUMBER - AZUCENA A PORRAL MD

Laboratory Demographics

  • CLIA Code: 05D0714884
  • Facility Name: AZUCENA A PORRAL MD
  • Facility Address: 5546 N ROSEMEAD BLVD, SUITE 102
    TEMPLE CITY, CA
    ZIP 91780
  • Facility Phone: 818 572-8421
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AZUCENA A. PORRAL MD
  • NPI Number: 1881793743
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0714884
LAB Type Physician Office
Facility Name AZUCENA A PORRAL MD
Street 5546 N ROSEMEAD BLVD, SUITE 102
City TEMPLE CITY
State CA
ZIP 91780
Phone 818 572-8421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director AZUCENA A. PORRAL MD

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