05D0723942 CLIA NUMBER - ROBERT A DEVEREAUX MD

Laboratory Demographics

  • CLIA Code: 05D0723942
  • Facility Name: ROBERT A DEVEREAUX MD
  • Facility Address: 11100 WARNER AVE 100
    FOUNTAIN VALLEY, CA
    ZIP 92708
  • Facility Phone: 714 957-9389
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT A. DEVEREAUX MD
  • NPI Number: 1043264781
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0723942
LAB Type Physician Office
Facility Name ROBERT A DEVEREAUX MD
Street 11100 WARNER AVE 100
City FOUNTAIN VALLEY
State CA
ZIP 92708
Phone 714 957-9389
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 ROBERT A. DEVEREAUX MD

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