05D0989497 CLIA NUMBER - ANTHONY T PHAN, MD INC

Laboratory Demographics

  • CLIA Code: 05D0989497
  • Facility Name: ANTHONY T PHAN, MD INC
  • Facility Address: 1189 SWALLOW LANE #110
    SIMI VALLEY, CA
    ZIP 93065
  • Facility Phone: 805 526-3213
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTHONY T. PHAN
  • NPI Number: 1124207006
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0989497
LAB Type Physician Office
Facility Name ANTHONY T PHAN, MD INC
Street 1189 SWALLOW LANE #110
City SIMI VALLEY
State CA
ZIP 93065
Phone 805 526-3213
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2025
Certificate Expiration Date 7/26/2027
Facility Type Physician Office
Lab Director ANTHONY T. PHAN

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