05D0866859 CLIA NUMBER - JONATHAN N TAM MD

Laboratory Demographics

  • CLIA Code: 05D0866859
  • Facility Name: JONATHAN N TAM MD
  • Facility Address: 105 N HILL AVE STE 203
    PASADENA, CA
    ZIP 91106
  • Facility Phone: 626 449-2800
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHNATHAN N. TAM, MD
  • NPI Number: 1013942952
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0866859
LAB Type Physician Office
Facility Name JONATHAN N TAM MD
Street 105 N HILL AVE STE 203
City PASADENA
State CA
ZIP 91106
Phone 626 449-2800
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 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Physician Office
Lab Director JOHNATHAN N. TAM, MD

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