05D1018990 CLIA NUMBER - ROBERT J WIELENGA MD

Laboratory Demographics

  • CLIA Code: 05D1018990
  • Facility Name: ROBERT J WIELENGA MD
  • Facility Address: 10835 NEW ST
    DOWNEY, CA
    ZIP 90241
  • Facility Phone: 562 923-9100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT J. WIELENGA MD
  • NPI Number: 1952469850
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1018990
LAB Type Physician Office
Facility Name ROBERT J WIELENGA MD
Street 10835 NEW ST
City DOWNEY
State CA
ZIP 90241
Phone 562 923-9100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director ROBERT J. WIELENGA MD

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