05D0937817 CLIA NUMBER - COMMUNITY HEALTH ALLIANCE OF PASADENA

Laboratory Demographics

CLIA Number: 05D0937817

Facility Name: COMMUNITY HEALTH ALLIANCE OF PASADENA

Facility Address:
1855 N FAIR OAKS AVE STE 200
PASADENA, CA
ZIP 91103
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Facility Phone Number: 626 993-1260

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1922429349

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0937817
LAB Type	Federally Qualified Health Center
Facility Name	COMMUNITY HEALTH ALLIANCE OF PASADENA
Street	1855 N FAIR OAKS AVE STE 200
City	PASADENA
State	CA
ZIP	91103
Phone	626 993-1260
CertificateType	4
CertificateEffectiveDate	10/1/2022
CertificateExpirationDate	9/30/2024
FacilityType	Waiver

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