05D0928533 CLIA NUMBER - BUNCHEN R FAN, MD

Laboratory Demographics

  • CLIA Code: 05D0928533
  • Facility Name: BUNCHEN R FAN, MD
  • Facility Address: 4124 NORTH ROSEMEAD STE A
    ROSEMEAD, CA
    ZIP 91770
  • Facility Phone: 626 285-2477
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BUNCHEN R. FAN, MD
  • NPI Number: 1588665657
  • Taxonomy: 174400000X - Specialist

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Physician Office
Lab Director BUNCHEN R. FAN, MD

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