05D0885611 CLIA NUMBER - ADVANCED REHAB CENTER OF TUSTIN

Laboratory Demographics

  • CLIA Code: 05D0885611
  • Facility Name: ADVANCED REHAB CENTER OF TUSTIN
  • Facility Address: 2210 E FIRST STREET
    SANTA ANA, CA
    ZIP 92705
  • Facility Phone: 714 547-7091
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SAMIR J. AZZAM
  • NPI Number: 1467005603
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 05D0885611
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ADVANCED REHAB CENTER OF TUSTIN
Street 2210 E FIRST STREET
City SANTA ANA
State CA
ZIP 92705
Phone 714 547-7091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2025
Certificate Expiration Date 2/10/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SAMIR J. AZZAM

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