05D1029808 CLIA NUMBER - MARK RODRIGUES MD ORANGE MEDICAL 3RD FLOOR

Laboratory Demographics

  • CLIA Code: 05D1029808
  • Facility Name: MARK RODRIGUES MD ORANGE MEDICAL 3RD FLOOR
  • Facility Address: 1140 W LA VETA AVE #470
    ORANGE, CA
    ZIP 92868
  • Facility Phone: 714 245-9900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK RODRIGUES MD
  • NPI Number: 1417977992
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1029808
LAB Type Physician Office
Facility Name MARK RODRIGUES MD ORANGE MEDICAL 3RD FLOOR
Street 1140 W LA VETA AVE #470
City ORANGE
State CA
ZIP 92868
Phone 714 245-9900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Physician Office
Lab Director MARK RODRIGUES MD

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