05D1021933 CLIA NUMBER - CITY OF HOPE HUNTINGTON BEACH

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Laboratory Demographics

CLIA Number: 05D1021933

Facility Name: CITY OF HOPE HUNTINGTON BEACH

Facility Address:
19671 BEACH BLVD, STE 315
HUNTINGTON BEACH, CA
ZIP 92648
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Facility Phone Number: 626 218-5912

Facility Type: Other - MULTISPECIALTY CLINIC

Certificate Type: Waiver

NPI Number: 1598814634

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	05D1021933
LAB Type	Other - MULTISPECIALTY CLINIC
Facility Name	CITY OF HOPE HUNTINGTON BEACH
Street	19671 BEACH BLVD, STE 315
City	HUNTINGTON BEACH
State	CA
ZIP	92648
Phone	626 218-5912
CertificateType	4
CertificateEffectiveDate	4/29/2024
CertificateExpirationDate	4/28/2026
FacilityType	Waiver

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