05D1015130 CLIA NUMBER - COMPASSIONATE CANCER CARE MEDICAL GROUP, INC

Laboratory Demographics

CLIA Number: 05D1015130

Facility Name: COMPASSIONATE CANCER CARE MEDICAL GROUP, INC

Facility Address:
11180 WARNER AVE, STE 351
FOUNTAIN VALLEY, CA
ZIP 92708
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Facility Phone Number: 714 698-0301

Facility Type: Independent

Certificate Type: Certificate of Compliance

NPI Number: 1548248032

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D1015130
LAB Type	Independent
Facility Name	COMPASSIONATE CANCER CARE MEDICAL GROUP, INC
Street	11180 WARNER AVE, STE 351
City	FOUNTAIN VALLEY
State	CA
ZIP	92708
Phone	714 698-0301
CertificateType	2
CertificateEffectiveDate	7/25/2023
CertificateExpirationDate	7/24/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024