05D0970605 CLIA NUMBER - RAEF M ELSANADI MD INC

Laboratory Demographics

  • CLIA Code: 05D0970605
  • Facility Name: RAEF M ELSANADI MD INC
  • Facility Address: 333 CORPORATE DR, #210
    LADERA RANCH, CA
    ZIP 92694
  • Facility Phone: 949 364-3582
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAEF M. ELSANADI
  • NPI Number: 1487744819
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0970605
LAB Type Physician Office
Facility Name RAEF M ELSANADI MD INC
Street 333 CORPORATE DR, #210
City LADERA RANCH
State CA
ZIP 92694
Phone 949 364-3582
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Physician Office
Lab Director RAEF M. ELSANADI

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