05D0996120 CLIA NUMBER - TAREK R NASSIF MD

Laboratory Demographics

  • CLIA Code: 05D0996120
  • Facility Name: TAREK R NASSIF MD
  • Facility Address: 416 W LAS TUNAS #304
    SAN GABRIEL, CA
    ZIP 91776
  • Facility Phone: 626 289-0130
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAREK R. NASSIF MD
  • NPI Number: 1730124611
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0996120
LAB Type Physician Office
Facility Name TAREK R NASSIF MD
Street 416 W LAS TUNAS #304
City SAN GABRIEL
State CA
ZIP 91776
Phone 626 289-0130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Physician Office
Lab Director TAREK R. NASSIF MD

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