05D0994355 CLIA NUMBER - ANTONIO CARBAYO MD INC DBA FULL HEALTH UNIVERSITY MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 05D0994355

Facility Name: ANTONIO CARBAYO MD INC DBA FULL HEALTH UNIVERSITY MEDICAL CLINIC

Facility Address:
1911 N BROADWAY
SANTA ANA, CA
ZIP 92706
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Facility Phone Number: 714 667-6900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1033149356

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0994355
LAB Type	Physician Office
Facility Name	ANTONIO CARBAYO MD INC DBA FULL HEALTH UNIVERSITY MEDICAL CLINIC
Street	1911 N BROADWAY
City	SANTA ANA
State	CA
ZIP	92706
Phone	714 667-6900
CertificateType	4
CertificateEffectiveDate	12/12/2023
CertificateExpirationDate	12/11/2025
FacilityType	Waiver

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