05D0955357 CLIA NUMBER - FERNANDO F MONTELONGO MD

Laboratory Demographics

CLIA Number: 05D0955357

Facility Name: FERNANDO F MONTELONGO MD

Facility Address:
932 EAST CHAPMAN AVENUE
ORANGE, CA
ZIP 92866
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Facility Phone Number: 714 997-9555

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245321165

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0955357
LAB Type	Physician Office
Facility Name	FERNANDO F MONTELONGO MD
Street	932 EAST CHAPMAN AVENUE
City	ORANGE
State	CA
ZIP	92866
Phone	714 997-9555
CertificateType	4
CertificateEffectiveDate	12/28/2022
CertificateExpirationDate	12/27/2024
FacilityType	Waiver

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