05D0993025 CLIA NUMBER - EMANATE HEALTH MEDICAL CARE FOUNDATION

Laboratory Demographics

  • CLIA Code: 05D0993025
  • Facility Name: EMANATE HEALTH MEDICAL CARE FOUNDATION
  • Facility Address: 412 W CARROLL AVE STE 108
    GLENDORA, CA
    ZIP 91741
  • Facility Phone: 626 852-0411
  • Facility Type: Other - 501C3
  • Facility Type: Microscopy
  • Lab Director: DR. WANDA A. BRADY
  • NPI Number: 1396806253
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0993025
LAB Type Other - 501C3
Facility Name EMANATE HEALTH MEDICAL CARE FOUNDATION
Street 412 W CARROLL AVE STE 108
City GLENDORA
State CA
ZIP 91741
Phone 626 852-0411
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Other - 501C3
Lab Director DR. WANDA A. BRADY

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