05D0902718 CLIA NUMBER - TAO T NGUYEN

Laboratory Demographics

CLIA Number: 05D0902718

Facility Name: TAO T NGUYEN

Facility Address:
6043 ATLANTIC BLVD
MAYWOOD, CA
ZIP 90270
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Facility Phone Number: 323 583-6516

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689693749

Taxonomy: 2080A0000X - Pediatrics
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

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
CertificateType	4
CertificateEffectiveDate	12/8/2023
CertificateExpirationDate	12/7/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024