05D1029375 CLIA NUMBER - MEDARDO C SUPNET, MD INC

Laboratory Demographics

  • CLIA Code: 05D1029375
  • Facility Name: MEDARDO C SUPNET, MD INC
  • Facility Address: 14359 PIONEER BLVD UNIT C
    NORWALK, CA
    ZIP 90650
  • Facility Phone: 562 864-7279
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MEDARDO C. SUPNET, MD
  • NPI Number: 1417069303
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D1029375
LAB Type Physician Office
Facility Name MEDARDO C SUPNET, MD INC
Street 14359 PIONEER BLVD UNIT C
City NORWALK
State CA
ZIP 90650
Phone 562 864-7279
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Physician Office
Lab Director MEDARDO C. SUPNET, MD

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