05D0988788 CLIA NUMBER - SAN GABRIEL ADHC ASSOC DBA ABC THERAPY CENTER

Laboratory Demographics

CLIA Number: 05D0988788

Facility Name: SAN GABRIEL ADHC ASSOC DBA ABC THERAPY CENTER

Facility Address:
1645 W VALLEY BLVD
ALHAMBRA, CA
ZIP 91803
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Facility Phone Number: 626 570-0778

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1457543118

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0988788
LAB Type	Other
Facility Name	SAN GABRIEL ADHC ASSOC DBA ABC THERAPY CENTER
Street	1645 W VALLEY BLVD
City	ALHAMBRA
State	CA
ZIP	91803
Phone	626 570-0778
CertificateType	4
CertificateEffectiveDate	7/9/2023
CertificateExpirationDate	7/8/2025
FacilityType	Waiver

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