05D0937008 CLIA NUMBER - JONATHAN TYE

Laboratory Demographics

  • CLIA Code: 05D0937008
  • Facility Name: JONATHAN TYE
  • Facility Address: 1250 SOUTH SUNSET AVENUE #202
    WEST COVINA, CA
    ZIP 91790
  • Facility Phone: 626 960-6588
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JONATHAN TYE
  • NPI Number: 1417057068
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0937008
LAB Type Physician Office
Facility Name JONATHAN TYE
Street 1250 SOUTH SUNSET AVENUE #202
City WEST COVINA
State CA
ZIP 91790
Phone 626 960-6588
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Physician Office
Lab Director JONATHAN TYE

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