05D0936983 CLIA NUMBER - MODERN CONCEPTS MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D0936983

Facility Name: MODERN CONCEPTS MEDICAL GROUP

Facility Address:
50 BELLFONTAINE STREET, SUITE 404
PASADENA, CA
ZIP 91105
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Facility Phone Number: 626 793-1931

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1194930420

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0936983
LAB Type	Physician Office
Facility Name	MODERN CONCEPTS MEDICAL GROUP
Street	50 BELLFONTAINE STREET, SUITE 404
City	PASADENA
State	CA
ZIP	91105
Phone	626 793-1931
CertificateType	3
CertificateEffectiveDate	8/30/2022
CertificateExpirationDate	8/29/2024
FacilityType	PPMP

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