05D0865456 CLIA NUMBER - CACERES MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0865456
  • Facility Name: CACERES MEDICAL GROUP
  • Facility Address: 8585 KNOTT AVENUE SUITE 101
    BUENA PARK, CA
    ZIP 90620
  • Facility Phone: 714 739-0393
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE A. CACERES
  • NPI Number: 1558437541
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0865456
LAB Type Physician Office
Facility Name CACERES MEDICAL GROUP
Street 8585 KNOTT AVENUE SUITE 101
City BUENA PARK
State CA
ZIP 90620
Phone 714 739-0393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director JOSE A. CACERES

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