05D1021518 CLIA NUMBER - EVERGREEN WORLD INC

Laboratory Demographics

  • CLIA Code: 05D1021518
  • Facility Name: EVERGREEN WORLD INC
  • Facility Address: 9856 WESTMINSTER AVENUE
    GARDEN GROVE, CA
    ZIP 92843
  • Facility Phone: 714 636-1818
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MINH DANG MD
  • NPI Number: 1760159198
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1021518
LAB Type Other
Facility Name EVERGREEN WORLD INC
Street 9856 WESTMINSTER AVENUE
City GARDEN GROVE
State CA
ZIP 92843
Phone 714 636-1818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Other
Lab Director MINH DANG MD

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This page was last updated on: 6/4/2025