05D1018039 CLIA NUMBER - DOROTHEA SPAMBALG MD

Laboratory Demographics

  • CLIA Code: 05D1018039
  • Facility Name: DOROTHEA SPAMBALG MD
  • Facility Address: 221 E WALNUT STREET SUITE 115
    PASADENA, CA
    ZIP 91101
  • Facility Phone: 626 577-0505
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOROTHEA E. SPAMBALG MD
  • NPI Number: 1568406809
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1018039
LAB Type Physician Office
Facility Name DOROTHEA SPAMBALG MD
Street 221 E WALNUT STREET SUITE 115
City PASADENA
State CA
ZIP 91101
Phone 626 577-0505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Physician Office
Lab Director DOROTHEA E. SPAMBALG MD

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