05D0719144 CLIA NUMBER - COLIMA MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D0719144
  • Facility Name: COLIMA MEDICAL CLINIC
  • Facility Address: 1850 SOUTH AZUSA #205
    HACIENDA HEIGHTS, CA
    ZIP 91745
  • Facility Phone: 626 964-2880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JANE S. GU
  • NPI Number: 1760585129
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0719144
LAB Type Physician Office
Facility Name COLIMA MEDICAL CLINIC
Street 1850 SOUTH AZUSA #205
City HACIENDA HEIGHTS
State CA
ZIP 91745
Phone 626 964-2880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Physician Office
Lab Director JANE S. GU

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