05D0893894 CLIA NUMBER - IRENE PE MD

Laboratory Demographics

  • CLIA Code: 05D0893894
  • Facility Name: IRENE PE MD
  • Facility Address: 12665 GARDEN GROVE BLVD STE 606
    GARDEN GROVE, CA
    ZIP 92843
  • Facility Phone: 714 530-5100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IRENE PE MD
  • NPI Number: 1154560415
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0893894
LAB Type Physician Office
Facility Name IRENE PE MD
Street 12665 GARDEN GROVE BLVD STE 606
City GARDEN GROVE
State CA
ZIP 92843
Phone 714 530-5100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Physician Office
Lab Director IRENE PE MD

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