05D1000671 CLIA NUMBER - MIR M MADANI MD

Laboratory Demographics

  • CLIA Code: 05D1000671
  • Facility Name: MIR M MADANI MD
  • Facility Address: 3801 KATELLA AVENUE,SUITE 310
    LOS ALAMITOS, CA
    ZIP 90720
  • Facility Phone: 562 598-2141
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIR M. MADANI MD
  • NPI Number: 1982611760
  • Taxonomy: 207RC0200X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1000671
LAB Type Physician Office
Facility Name MIR M MADANI MD
Street 3801 KATELLA AVENUE,SUITE 310
City LOS ALAMITOS
State CA
ZIP 90720
Phone 562 598-2141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2024
Certificate Expiration Date 6/18/2026
Facility Type Physician Office
Lab Director MIR M. MADANI MD

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