05D0955927 CLIA NUMBER - IBRAHIM I HANNA MD

Laboratory Demographics

  • CLIA Code: 05D0955927
  • Facility Name: IBRAHIM I HANNA MD
  • Facility Address: 640 W FOOTHILL BLVD STE 100
    GLENDORA, CA
    ZIP 91741
  • Facility Phone: 626 335-4041
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IBRAHIM I. HANNA MD
  • NPI Number: 1407898653
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0955927
LAB Type Physician Office
Facility Name IBRAHIM I HANNA MD
Street 640 W FOOTHILL BLVD STE 100
City GLENDORA
State CA
ZIP 91741
Phone 626 335-4041
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Physician Office
Lab Director IBRAHIM I. HANNA MD

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