05D1010819 CLIA NUMBER - SAN JUAN PEDIATRICS, INC

Laboratory Demographics

  • CLIA Code: 05D1010819
  • Facility Name: SAN JUAN PEDIATRICS, INC
  • Facility Address: 27372 CALLE ARROYO
    SAN JUAN CAPISTRANO, CA
    ZIP 92675
  • Facility Phone: 949 388-9009
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHRAF FAHIM
  • NPI Number: 1073793790
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D1010819
LAB Type Physician Office
Facility Name SAN JUAN PEDIATRICS, INC
Street 27372 CALLE ARROYO
City SAN JUAN CAPISTRANO
State CA
ZIP 92675
Phone 949 388-9009
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Physician Office
Lab Director ASHRAF FAHIM

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