05D0944058 CLIA NUMBER - SHYH-MINE LII MD

Laboratory Demographics

  • CLIA Code: 05D0944058
  • Facility Name: SHYH-MINE LII MD
  • Facility Address: 3859 NORTH ROSEMEAD BOULEVARD
    ROSEMEAD, CA
    ZIP 91770
  • Facility Phone: 626 572-4044
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHYH MINE LII
  • NPI Number: 1922150267
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0944058
LAB Type Physician Office
Facility Name SHYH-MINE LII MD
Street 3859 NORTH ROSEMEAD BOULEVARD
City ROSEMEAD
State CA
ZIP 91770
Phone 626 572-4044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Physician Office
Lab Director SHYH MINE LII

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