05D0902718 CLIA NUMBER - TAO T NGUYEN

Laboratory Demographics

  • CLIA Code: 05D0902718
  • Facility Name: TAO T NGUYEN
  • Facility Address: 6043 ATLANTIC BLVD
    MAYWOOD, CA
    ZIP 90270
  • Facility Phone: 323 583-6516
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAO T. NGUYEN
  • NPI Number: 1689693749
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0902718
LAB Type Physician Office
Facility Name TAO T NGUYEN
Street 6043 ATLANTIC BLVD
City MAYWOOD
State CA
ZIP 90270
Phone 323 583-6516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Physician Office
Lab Director TAO T. NGUYEN

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