05D0975225 CLIA NUMBER - OPTIMUM MEDICAL CLINICS INC

Laboratory Demographics

  • CLIA Code: 05D0975225
  • Facility Name: OPTIMUM MEDICAL CLINICS INC
  • Facility Address: 20072 SW BIRCH ST, STE 100
    NEWPORT BEACH, CA
    ZIP 92660
  • Facility Phone: 949 757-1150
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLEN SONG
  • NPI Number: 1649354366
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0975225
LAB Type Physician Office
Facility Name OPTIMUM MEDICAL CLINICS INC
Street 20072 SW BIRCH ST, STE 100
City NEWPORT BEACH
State CA
ZIP 92660
Phone 949 757-1150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Physician Office
Lab Director ELLEN SONG

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