05D0928533 CLIA NUMBER - BUNCHEN R FAN, MD

Laboratory Demographics

CLIA Number: 05D0928533

Facility Name: BUNCHEN R FAN, MD

Facility Address:
4124 NORTH ROSEMEAD STE A
ROSEMEAD, CA
ZIP 91770
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Facility Phone Number: 626 285-2477

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1588665657

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0928533
LAB Type	Physician Office
Facility Name	BUNCHEN R FAN, MD
Street	4124 NORTH ROSEMEAD STE A
City	ROSEMEAD
State	CA
ZIP	91770
Phone	626 285-2477
CertificateType	4
CertificateEffectiveDate	4/17/2023
CertificateExpirationDate	4/16/2025
FacilityType	Waiver

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