05D0994368 CLIA NUMBER - ALTAMED HEALTH SERVICES CORPORATION RUGBY

Laboratory Demographics

  • CLIA Code: 05D0994368
  • Facility Name: ALTAMED HEALTH SERVICES CORPORATION RUGBY
  • Facility Address: 1900 E SLAUSON AVE STE B
    HUNTINGTON PARK, CA
    ZIP 90255
  • Facility Phone: 323 277-7678
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: ESIQUIO G. CASILLAS MD
  • NPI Number: 1205041746
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0994368
LAB Type Community Clinic
Facility Name ALTAMED HEALTH SERVICES CORPORATION RUGBY
Street 1900 E SLAUSON AVE STE B
City HUNTINGTON PARK
State CA
ZIP 90255
Phone 323 277-7678
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Community Clinic
Lab Director ESIQUIO G. CASILLAS MD

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