05D1006944 CLIA NUMBER - JOHN A FAGAN, MD, INC DBA ASPEN FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 05D1006944
  • Facility Name: JOHN A FAGAN, MD, INC DBA ASPEN FAMILY MEDICINE
  • Facility Address: 10787 LAUREL ST
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 909 982-7741
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN A. FAGAN MD
  • NPI Number: 1306904628
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1006944
LAB Type Physician Office
Facility Name JOHN A FAGAN, MD, INC DBA ASPEN FAMILY MEDICINE
Street 10787 LAUREL ST
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 909 982-7741
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2024
Certificate Expiration Date 12/3/2026
Facility Type Physician Office
Lab Director JOHN A. FAGAN MD

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